内镜窄带成像技术对Barrett食管合并 早期食管腺癌的诊断价值

Narrow-band imaging endoscopy for detecting early esophageal adenocarcinoma in patients with Barrett's esophagus

摘要:

目的 探讨内镜窄带成像技术（NBI）对Barrett食管（BE）患者早期食管腺癌的诊断价值。方法 选取176例内镜诊断为BE的患者，分别在常规白光摸式、NBl模式及1.2％碘溶液染色模式下观察，对所有可疑病变部位均取活检，所有病变均以病理结果作为诊断标准，分别与病理诊断结果对比。结果 176例患者，病理诊断BE的160例，其中3例被诊断为早期食管腺癌（EAC），将3种方法的结果相比，对敏感度、特异度、准确度、阳性预测值、阴性预测值、阳性似然比和阴性似然比进行比较。NBI和复方碘溶液的敏感性和阴性预测值均为100%，两者的特异性分别为89.8%和91.7%，均优于常规白光内镜。 结论 NBI技术对BE合并早期食管腺癌具有高灵敏度和高阴性预测值，它的结果与复方碘溶液染色所获得的结果具有可比性。

Abstract:

【Objective】 To evaluate the role of narrow-band imaging endoscopy for detecting early esophageal adenocarcinoma in patients with Barrett's esophagus (BE). 【Methods】 A total of 176 patients diagnosed BE by endoscopy were enrolled in this study. They were observed by common endoscopy, narrow-band imaging (NBI), and then 1.2％ Lugoul's iodine staining endoscope. The suspected lesions were mapped, recorded, and sent for biopsy. 【Results】 Among the 176 patients, 160 patients were diagnosed by histology. Of the 160 patients, 3 were diagnosed with early esophageal adenocarcinoma (EAC).The three methods were compared regarding sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood value and negative likelihood value, respectively. Sensitivity and negative predictive value by NBI and iodine staining endoscope were both 100%, specificity was 89.8% and 91.7%, which were better than common endoscopy. 【Conclusion】 NBI technology has high sensitivity and negative predictive value for detecting early esophageal adenocarcinoma, and it has comparable results with those obtained with Lugol's staining.