【摘要】 目的探讨窄带成像放大内镜(ME-NBI)联合AⅠ(醋酸+靛胭脂)三明治染色法对平坦型胃癌的诊断价值。方法对2016年1月-2017年1月南方医院深圳消化病诊疗中心及南方医科大学南方医院70例胃镜检查发现平坦型可疑胃癌病灶,分别使用白光内镜、ME-NBI、放大内镜+AⅠ三明治染色法并应用VS分类标准判断其病变性质,对可疑病灶靶向活检,以病理组织学结果为金标准,应用SPSS 16.0软件包进行统计学分析,分析其诊断的准确性。结果 70例患者中,病理组织学证实癌性病变为13处,非癌性病变57处。白光内镜下诊断胃癌的敏感度、特异度、Kappa值分别为46.2%、73.7%、0.360,ME-NBl下对应值分别84.6%、84.2%和0.819,AⅠ三明治染色+放大内镜对应值分别为86.2%、93%和0.833;应用ROC工作曲线提示AIM染色+放大内镜、ME-NBl诊断胃癌的准确性明显高于白光内镜,差异有统计学意义(P<0.01);AⅠ三明治染色法+弱放大较ME-NBl更能确定平坦型胃癌的边界,两者比较有统计学意义(P<0.01)。结论 ME-NBI与AⅠ三明治染色法结合,能鉴别平坦型病灶病变性质,特别是可提高平坦型胃癌的诊断准确性。更多还原

【Abstract】 Objective To study the diagnostic value of NBI-ME combine with AⅠ chromoendoscopy using VS classification standard for flat gastric cancer. Methods A total of 70 patients with suspected early gastric cancer whose gastric mucosa showed flat lesions were collected from January 2016 to January 2017. The lesions were observed under white light endoscopy,ME-NBI and AⅠ chromoendoscopy using VS classification standard,then underwent biopsy.Biopsy were conducted as gold standard. Results A total of 13 patients were confirmed tumor and 57 patients were nontumorous lesions in 106 patients;The sensitivity,specificity,positive Kappa value of white light endoscopy in the diagnosis of early gastric carcinoma lesions were 46.2%,73.7%,0.360,respectively,while the these variables of NBI-ME for early gastric carcinoma lesions were 84.6%,84.2%,0.819 and 86.2%,93%,0.833 with chromoendoscopy;The accuracy of NBI-ME and AⅠ chromoendoscopy for early gastric carcinoma lesions was significantly higher than that of white light endoscopy(P<0.01);ME-NBl can more accurately determine the scope of the flat type of gastric cancer comparing with chromoendoscopy. Conclusion NBI-ME congbined with AⅠ chrome are convenient and effective in the diagnosis of early gastric carcinoma flat lesions with VS classification standard and good clinical application value.更多还原