窄带成像技术对胃黏膜高级别上皮内瘤变患者临床疗效的影响

Effect of narrow band imaging on the clinical efficacy of high grade gastric mucosal epithelial neoplasia

摘要:

目的??探究窄带成像技术（NBI）对胃黏膜高级别上皮内瘤变（HGIN）患者临床疗效的影响。方法?选取2006年6月-2016年6月该院接收治疗的96例胃黏膜HGIN患者为研究对象，采用随机数表法将患者分为对照组和观察组，各48例。对照组患者采用内镜黏膜下剥离术（ESD）治疗，观察组患者采用NBI联合ESD治疗。比较两组患者的各项手术情况、术后病理分型和并发症发生情况。结果?观察组患者的手术时间、切缘阳性率均低于对照组，病灶直径、一次性整块切除率和治愈性切除率均高于对照组，差异具有统计学意义（P <0.05）。观察组术后病理分型包括27例HGIN癌变患者，15例HGIN伴局灶癌变患者和6例高-中分化腺癌患者，对照组术后病理分型包括1例低级别上皮内瘤变（LGIN）患者，33例HGIN癌变患者，11例HGIN伴局灶癌变患者和3例高-中分化腺癌患者，差异无统计学意义（P >0.05）。观察组与对照组患者的并发症总发生率分别为6.25%和22.92%，观察组明显低于对照组，差异具有统计学意义（P <0.05）。结论?采用NBI联合内镜治疗胃黏膜HGIN患者能够显著提高病灶的整块完整切除率和治愈性切除率，缩短手术时间，降低并发症发生率。

关键词:窄带成像技术;内镜黏膜下剥离术;高级别;胃黏膜上皮内瘤变

Abstract:

Objective?To explore the effect of narrow band imaging on the clinical outcomes of patients with high grade intraepithelial neoplasia in gastric mucosa.?Methods?From June 2006 to June 2016, 96 patients of gastric high-grade intraepithelial neoplasia were enrolled in the study. All patients were divided into control group and observation group using a random number table method, 48 cases in each. In control group, patients were treated with endoscopic submucosal dissection treatment, while in observation group, patients were treated with narrowband imaging combined with endoscopic submucosal dissection treatment. The operation time, pathological type and occurrence of complications of the two groups were compared.?Results?The operation time, positive margin rates in observation group were lower than that in control group, while tumor diameter, one en bloc resection rate and curative resection rate was higher, the difference was statistically significant (P < 0.05). Pathological type: observation group includes 27 cases of HGIN, 15 cases of focal HGIN and 6 cases of high-moderately differentiated adenocarcinoma; while in control group, including 1 case of LGIN, 33 cases of HGIN, 11 cases of focal HGIN and 3 cases of high-differentiated adenocarcinoma patients, the difference was not statistically significant (P > 0.05). Overall incidence of complications in observation group and control group were 6.25% and 22.92% respectively; which shown observation group has significantly lower rate than control group, the difference was statistically.?Conclusion?Narrow-band imaging combined with endoscopy in the treatment of gastric neoplasia in patients with high-grade intraepithelial lesions can significantly improve the cure rate and complete resection en bloc resection rate, shorten the operation time, reduce the incidence of complications.

Key words:narrow band imaging technology; endoscopic submucosal dissection; high-level; intraepithelial gastric epithelial