摘要
目的评估放大内镜结合窄带成像技术（ME—NBI）在胃黏膜病变靶向活检中的意义。方法前瞻性收集2011年5月至2013年5月经普通白光内镜检查发现胃部可疑早期病变并取得活检病理者纳入研究，进一步行ME-NBI检查并指导再次活检，所有患者接受内镜下治疗。以内镜切除病理结果为金标准，比较2次内镜活检病理的诊断准确度。结果研究纳入113例患者。白光内镜活检病理、ME-NBI靶向活检病理与最终病理相比，总体符合率由22．1％（25／113）提高到54．0％（61／113，P〈0．0001）。对早期胃癌和高级别上皮内瘤变的诊断，ME-NBI靶向病理与白光内镜活检病理的灵敏度分别为70．9％和37．9％（P〈0．0001）；特异度均为90．0％；准确度分别为72．6％和42．5％（P〈0．0001）；阳性预测值分别为98．6％和97．5％，阴性预测值分别为23．1％和12．3％，差异均无统计学意义（P均〉0．05）。ME—NBI靶向活检病理相对白光内镜活检病理的总体进展率为46．9％（53／113）。结论对于早期胃癌的诊断，ME-NBI靶向活检病理结果显著优于普通白光内镜，可为内镜切除治疗提供更好的依据。
Objective To evaluate target biopsy using magnifying endoscopy combined with narrow band imaging（ME-NBI） in suspicious gastric lesions. Methods A total of 113 patients with suspicious early gastric lesions under white light endoscopy（WLE） were prospectively enrolled and biopsied between May 2011 and May 2013. Further endoscopy was conducted using ME-NBI and target biopsy. All patients received endoscopic resection（ER）. Outcomes of WLE biopsy and target biopsy were compared, with histology of ER specimen as golden standard. Results The overall diagnostic accuracy of WLE biopsy and target biopsy were 22. 1% （25/113） and 54.0% （61/113）, （P 〈 0.0001 ）. In diagnosing early gastric cancer （EGC） and high-grade intraepithelial neoplasia （ HGIN）, the sensitivity of target and WLE biopsy were 70. 9% and 37. 9% （P 〈0. 0001 ）, respectively. The specificity were 90. 0% in both groups. The accuracy rates were 72. 6% and 42. 5%, respectively（P 〈0. 0001 ）. The positive predictive values were 98. 6% and 97. 5% （P 〉0. 05）. The negative predictive values were 23.1% and 12. 3% （P 〉0. 05）, respectively. The overall progression rate of target biopsy was 46.9% （53/113）. Conclusion ME-NBI target biopsy is superior to traditional WLE biopsy in diagnosis of early gastric cancer.
出处
《中华消化内镜杂志》
2014年第8期455-458,共4页
Chinese Journal of Digestive Endoscopy
关键词
胃肿瘤
内窥镜
治疗结果
病理学
Stomach neoplasms
Endoscopes
Treatment outcome
Pathology
作者简介
通信作者：李晓波，Email：lxb_1969@163．com
