早期胃癌和上皮内瘤变在放大内镜窄带成像技术下的表现

Research on manifestations of early gastric cancer and intraepithelial neoplasia under magnifying endoscopy with narrow-band imaging

摘要:

目的 研究放大内镜窄带成像技术（ME-NBI）在早期胃癌和上皮内瘤变中的诊断效能，以及相关病变的ME-NBI下表现。方法 回顾性分析131例早期胃癌和上皮内瘤变病例的临床资料。分析病变的ME-NBI下表现，比较ME-NBI和白光内镜（WLI）+活检两种方法在早期胃癌和上皮内瘤变中的诊断效能。研究不同程度病变的ME-NBI下表现。结果 ME-NBI诊断早期胃癌、高级别上皮内瘤变（HGIN）和低级别上皮内瘤变（LGIN）的诊断准确率分别为77.96%、77.96%和77.96%；WLI+活检诊断以上病变的准确率分别为60.53%、58.47%和69.70%，两种检查方法诊断LGIN的准确率比较，差异无统计学意义（P > 0.05），两种检查方法诊断早期胃癌和HGIN的准确率比较，差异有统计学意义（P < 0.05）。在LGIN中，脑回样腺管出现率最高，为60.46%。乳头状腺管和绒毛状腺管在LGIN和早期胃癌中出现率较高，分别为57.14%和52.00%。结论 ME-NBI诊断早期胃癌准确率较WLI+活检高。边界线在分化型早期胃癌和上皮内瘤变中有较高的敏感性。绒毛状和乳头状微腺管结构在早期胃癌中出现率更高。脑回状微腺管在LGIN中出现率明显高于其他病变组。

Abstract:

Objective To study the diagnostic efficacy of magnifying endoscopy with narrow-band imaging (ME-NBI) in the diagnosis of early gastric cancer and intraepithelial neoplasia, and their manifestations under ME-NBI.Methods In this retrospective research, we enrolled 131 cases of early gastric cancer and intraepithelial neoplasia. Then analyze the ME-NBI manifestations of lesions, compare the diagnostic efficacy of ME-NBI and white light endoscopy (WLI) + biopsy methods in early gastric cancer and intraepithelial neoplasia and study the ME-NBI manifestations of different degrees of lesions.Results The diagnostic accuracy of ME-NBI for diagnosing early gastric cancer, high grade intraepithelial neoplasia (HGIN) and low grade intraepithelial neoplasia (LGIN) was 77.96%, 77.96% and 77.96%, respectively. The diagnostic accuracy of WLI + biopsy for above lesions was 60.53%, 58.47% and 69.70%, respectively. There was no statistically significant difference in the accuracy of two diagnostic methods for LGIN (P > 0.05), while there was a statistically significant difference in the accuracy of two diagnostic methods for early gastric cancer and HGIN (P < 0.05). In LGIN, the highest rate of cerebral gyrus glandular duct emergence was 60.46%. The incidence of papillary and villous ducts is highest in HGIN and early gastric cancer, with rates of 57.14% and 52.00%, respectively.Conclusion ME-NBI has more diagnostic efficiency in early gastric cancer than WLI+biopsy. The demarcation line has better sensitivity in differentiated early gastric cancer and intraepithelial neoplasia. Micro-surface tube like villous, papillary structures has higher occurrence rates in early gastric cancer. The cerebral gyrus microglandular duct appeares significantly higher in LGIN than other groups.