放大内镜结合窄带成像技术和醋酸-靛胭脂染色联合多层螺旋CT对早期胃癌及癌前病变的诊断效能及临床意义

Magnifying endoscopy combined with narrow-band imaging, acetate-indigo rouge staining combined with multi-slice spiral CT in the diagnosis of early gastric cancer and precancerous lesions and clinical significance

摘要:

目的 分析放大内镜结合窄带成像技术（ME-NBI）和醋酸-靛胭脂染色联合多层螺旋CT对早期胃癌及癌前病变的诊断效能及临床意义。方法 选取2019年2月－2022年3月于该院就诊的202例疑似早期胃癌及癌前病变患者作为研究对象，所有患者均进行ME-NBI、醋酸-靛胭脂染色和多层螺旋CT检测；采用受试者操作特征曲线（ROC curve），分析不同检查方法对早期胃癌及癌前病变的诊断价值，以胃癌病理结果为金标准，采用四格表，分析ME-NBI、醋酸-靛胭脂染色联合多层螺旋CT和三者联合对早期胃癌及癌前病变的诊断价值。结果 ME-NBI和醋酸-靛胭脂染色两者联合检查的图像质量明显高于各自单独检查，差异均有统计学意义（P < 0.05）。早期胃癌及癌前病变患者临床特征中的分化程度比较，差异有统计学意义（P < 0.05）。ME-NBI诊断早期胃癌及癌前病变的曲线下面积（AUC）为0.853，准确度为85.64%，敏感度为88.37%，特异度为83.62%，醋酸-靛胭脂染色诊断早期胃癌及癌前病变的AUC为0.814，准确度为81.68%，敏感度为83.72%，特异度为80.17%，多层螺旋CT诊断早期胃癌及癌前病变的AUC为0.804，准确度为80.69%，敏感度为82.56%，特异度为79.31%，三者联合诊断早期胃癌及癌前病变的AUC为0.893，准确度为89.60%，敏感度为93.02%，特异度为87.07%。结论 ME-NBI和醋酸-靛胭脂染色联合多层螺旋CT，对早期胃癌及癌前病变具有较高的诊断效能，可在临床中推广使用。

Abstract:

Objective To analyze the diagnostic efficacy and clinical significance of magnifying endoscopy combined with narrow-band imaging (ME-NBI), acetate-indigo rouge staining and multi-slice spiral CT for early gastric cancer and precancerous lesions.Methods 202 patients with suspected early gastric cancer and precancerous lesions from February 2019 to March 2022 were regarded as the subjects of this study, all the patients underwent ME-NBI, acetate-indigo rouge staining, and multi-slice spiral CT examination; The diagnostic value of different examination methods for early gastric cancer and precancerous lesions was analyzed using the receiver operator characteristic curve (ROC curve), using the pathological results of gastric cancer as the gold standard, the diagnostic value of ME-NBI, acetate-indigo rouge staining combined with multi-slice spiral CT and their combination in early gastric cancer and precancerous lesions was analyzed using a four grid table.Results The image quality of ME-NBI and acetate-indigo rouge staining combined examinations was significantly higher than that of their respective independent examinations (P < 0.05). There was significant difference in the degree of differentiation in the clinical features of patients with early gastric cancer and precancerous lesions (P < 0.05). The area under the curve (AUC) of ME-NBI for the diagnosis of early gastric cancer and precancerous lesions was 0.853, the accuracy was 85.64%, the sensitivity was 88.37%, and the specificity was 83.62%. The AUC of acetate-indigo rouge staining for the diagnosis of early gastric cancer and precancerous lesions was 0.814, the accuracy was 81.68%, the sensitivity was 83.72%, and the specificity was 80.17%. The AUC of multi-slice spiral CT for the diagnosis of early gastric cancer and precancerous lesions was 0.804, with an accuracy of 80.69%, a sensitivity of 82.56%, and a specificity of 79.31%. And the AUC of the three methods combined to diagnose early gastric cancer and precancerous lesions was 0.893, with an accuracy of 89.60%, a sensitivity of 93.02%, and a specificity of 87.07%.Conclusion ME-NBI, acetate-indigo rouge staining combined with multi-slice spiral CT has high diagnostic efficacy in early gastric cancer and precancerous lesions, and can be used in clinical practice.