摘要
目的探讨人工智能(AI)辅助消化内镜在早期胃癌及癌前病变诊断中的临床应用价值。方法将2024年8月至12月于内蒙古自治区人民医院行无痛胃镜检查且符合纳入排除标准的患者随机分配至AI胃镜组和传统胃镜组。比较2组内镜下病变检出率和活检组织的病理特征。结果AI胃镜组在胃镜检查和胃部观察中位时间少于传统胃镜组(5.00 min vs.5.80 min,3.15 min vs.4.00 min,均P<0.05)的情况下,隆起糜烂/黏膜粗糙和胃息肉的检出率优于传统胃镜组(41.7%vs.33.6%,30.6%vs.23.0%,均P<0.05)。在活检率(48.4%vs.46.2%,P=0.440)和活检次数中位数[0(0,1)vs.0(0,1),P=0.472]均未发现差异有统计学意义的情况下,AI胃镜组活检组织的高危病变检出率高于传统胃镜组(59.6%vs.51.8%,P=0.028),且低级别上皮内瘤变的检出率高于传统胃镜组(33.9%vs.24.2%,P=0.027)。AI胃镜组的癌前病变(25.2%vs.17.7%,P=0.024)和癌前状态(27.5%vs.20.1%,P=0.032)检出率高于传统胃镜组。结论人工智能辅助消化内镜显著提高癌前病变和癌前状态的检出率,且研究期间未观察到系统导致的不良事件,其安全可控,具有较高的临床应用价值。
Objective To investigate the application of artificial intelligence(AI)-assisted digestive endoscopy in the diagnosis of early gastric cancer and precancerous lesions.Methods Patients who underwent painless gastroscopy at Endoscopy Center in Inner Mongolia People’s Hospital from August to December 2024 and met the inclusion and exclusion criteria were randomly assigned into the AI-assisted gastroscopy group and traditional gastroscopy group.The detection rate of endoscopic lesions and pathological characteristics of biopsies were compared between two groups.Results The detection rate of elevated erosion/mucosal roughness and gastric polyps in the AI-assisted gastroscopy group under endoscopy was better than that in the traditional gastroscopy group(41.7%vs.33.6%,30.6%vs.23.0%,both P<0.05),while also achieving shorter median time for gastroscopy examination and gastric observation(5.00 min vs.5.80 min,3.15 min vs.4.00 min,both P<0.05).In the absence of significant differences in biopsy rate(48.4%vs.46.2%,P=0.440)and the median number of biopsies[0(0,1)vs.0(0,1),P=0.472],the detection rate of high-risk lesions in the AI-assisted gastroscopy group was higher than that in the traditional gastroscopy group(59.6%vs.51.8%,P=0.028),and the detection rate of low-grade intraepithelial neoplasia in the AI-assisted gastroscopy group was significantly higher than that in the traditional gastroscopy group(33.9%vs.24.2%,P=0.027).In the AIassisted gastroscopy group,the detection rate of precancerous lesions(25.2%vs.17.7%,P=0.024)and precancerous condition(27.5%vs.20.1%,P=0.032)was higher than that in the traditional gastroscopy group.Conclusions AI-assisted digestive endoscopy significantly improves the detection rate of precancerous lesions and precancerous condition,and no adverse events caused by the system are observed throughout the study.It is safe and controllable,and has significant clinical application value.
作者
王毓龙
王潇
吴日娜
曹鑫宇
赵贵君
WANG Yulong;WANG Xiao;WU Rina;CAO Xinyu;ZHAO Guijun(Digestive Center of Inner Mongolia People’s Hospital,Inner Mongolia Key Laboratory of Endoscopic Digestive Diseases,Hohhot 010017,China)
出处
《新医学》
2025年第12期1178-1186,共9页
Journal of New Medicine
基金
国家自然科学基金(81960539)
内蒙古医学科学院公立医院科研联合基金科技项目(2023GLLH0024)。
关键词
人工智能
电子胃镜
早期胃癌
癌前病变
癌前状态
Artificial intelligence
Electronic gastroscopy
Early gastric cancer
Precancerous lesion
Precancerous condition
