摘要
目的探讨窄带成像放大内镜(NBI-ME)诊断早期食管癌的临床价值。方法选取2018年1月至2021年1月间上海市金山区亭林医院收治的经病理证实的200例高级别上皮内瘤变或早期食管癌患者,采用随机数表法分为普通内镜组、超声内镜组、NBI-ME组和窄带成像(NBI)-碘染色内镜组,每组50例。普通内镜组患者采用普通内镜检查,超声内镜组患者采用超声内镜检查,NBI-ME组患者采用NBI-ME检查,NBI-碘染色内镜组患者采用碘染色内镜法检查。以病理诊断结果为金标准,分析四组内镜检查结果的准确性和敏感度及与病理诊断的一致性。结果病理结果显示,普通内镜组患者早期食管癌42例,高级别上皮内瘤变8例;超声内镜组早期食管癌47例,高级别上皮内瘤变3例;NBI-ME组早期食管癌40例,高级别上皮内瘤变10例;NBI-碘染色内镜组早期食管癌44例,高级别上皮内瘤变6例。内镜诊断结果显示,普通内镜组患者早期食管癌28例,高级别上皮内瘤变14例,其余未检出;超声内镜组早期食管癌39例,高级别上皮内瘤变11例;NBI-ME组早期食管癌35例,高级别上皮内瘤变15例;NBI-碘染色内镜组早期食管癌39例,高级别上皮瘤变5例,其余未检出。Kappa一致性检验显示,普通内镜组与病理诊断结果一致性一般,超声内镜组、NBI-ME组和NBI-碘染色内镜组与病理诊断结果一致性均高。四种诊断方法的准确性和敏感度比较,差异有统计学意义(P<0.05)。NBI-碘染色内镜组诊断准确性最高,NBI-ME组敏感度最高,超声内镜组、NBI-ME组和NBI-碘染色内镜组的敏感度与准确性均高于普通内镜组,差异均有统计学意义(均P<0.05)。结论碘染色内镜法和NBI-ME对早期食管癌的诊断具有较高的准确率,与超声内镜相当,优于普通内镜,为食管癌早期诊断和治疗提供理论依据。
Objective To compare the significance of narrow band imaging(NBI)magnifying endoscopy(ME)in the diagnosis of early esophageal cancer.Methods Two hundred patients with highgrade intraepithelial neoplasia or early esophageal cancer confirmed by pathology at Shanghai Tinglin Hospital of Jinshan District from January 2018 to January 2021 were selected as the research subjects.They were randomly divided into an ordinary endoscopy group,an endoscopic ultrasonography group,an NBI-ME group and an NBI-iodine staining endoscopy group with 50 patients in each group.The pathological diagnostic results were used as the references,the accuracy and sensitivity of the four groups and the consistency between the different diagnostic results were analyzed.Results According to the pathological diagnostic results,42 patients was diagnosed with early esophageal cancer and 8 patients was diagnosed with high-grade intraepithelial neoplasia by ordinary endoscopy,47 patients was diagnosed with early esophageal cancer and 3 patients was diagnosed with high-grade intraepithelial neoplasia by endoscopic ultrasonography,40 patients was diagnosed with early esophageal cancer and 10 patients was diagnosed with high-grade intraepithelial neoplasia by NBI-ME group and 44 patients was diagnosed with early esophageal cancer and 6 patients was diagnosed with high-grade intraepithelial neoplasia.According the diagnostic results of endoscopy,28 patients was diagnosed with early esophageal cancer and 14 patients was diagnosed with high-grade intraepithelial neoplasia by ordinary endoscopy,39 patients was diagnosed with early esophageal cancer and 11 patients was diagnosed with high-grade intraepithelial neoplasia by endoscopic ultrasonography,35 patients was diagnosed with early esophageal cancer and 15 patients was diagnosed with high-grade intraepithelial neoplasia by NBI-ME and 39 patients was diagnosed with early esophageal cancer and 5 patients was diagnosed with high-grade intraepithelial neoplasia by NBI-iodine staining endoscopy.Kappa consistency test showed that the diagnostic results of common endoscopy group were generally consistent with those of pathological diagnosis,and the diagnostic of endoscopic ultrasonography was highly consistent with pathological diagnosis,NBIME and pathological diagnosis(all P<0.05).There were significant differences in the accuracy and sensitivity of the four diagnostic methods(all P<0.05).The accuracy was the highest in the endoscopic ultrasonography group and the sensitivity was the highest in the NBI-ME group.The sensitivity and accuracy were higher in endoscopic ultrasonography group,NBI-ME group and NBI-iodine staining endoscopic group than in the ordinary endoscopic group(all P<0.05).Conclusion Iodine staining endoscopy and n NBIME showed high accuracy in the diagnosis of early esophageal cancer,which was comparable with that of endoscopic ultrasonography and was superior to that of ordinary endoscopy.It provides a theoretical basis for the diagnosis and treatment of early esophageal cancer in the future.
作者
杨秀红
刘雪利
孙茂源
肖强
谈朋生
YANG Xiu-hong;LIU Xue-li;SUN Mao-yuan;XIAO Qiang;TAN Peng-sheng(Department of Digestive Medicine,Shanghai Tinglin Hospital of Jinshan District,Shanghai 201505,China)
出处
《中国肿瘤临床与康复》
2021年第3期281-284,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
食管肿瘤
早期诊断
窄带成像
放大内镜
碘染色
超声内镜
Esophageal neoplasms
Early diagnosis
Narrow band imaging
Magnifying endoscopy
Iodine staining
Endoscopic ultrasonography
作者简介
杨秀红,女,副主任医师,主要从事消化道肿瘤内镜治疗专业。
