| 胡莹,丁百静,李宗先.放大内镜联合窄带成像、醋酸与靛胭脂染色内镜对胃黏膜病变的临床价值[J].安徽医药,2019,23(5):881-884. |
| 放大内镜联合窄带成像、醋酸与靛胭脂染色内镜对胃黏膜病变的临床价值 |
| The clinical value of magnifying endoscopy combined with narrow-band imaging,acetic acid added to indigo carmine staining for the gastric mucosal lesions |
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| DOI：10.3969/j.issn.1009-6469.2019.05.010 |
| 中文关键词: 胃肿瘤 胃炎 胃黏膜 胃镜检查 靛卡红 着色剂 醋酸 癌症早期检测 窄带成像 |
| 英文关键词: Stomach neoplasms Gastritis Gastric mucosa Gastroscopy Indigo carmine Coloring agents Acetic acid Early detection of cancer Narrow band imaging |
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| 目的 探讨放大内镜联合窄带成像、醋酸-靛胭脂染色内镜对胃黏膜病变的诊断及应用价值。方法 选择2015年9月至2016年12月于芜湖市第二人民医院检查疑似早癌及癌前病变的134例病人依次进行普通白光内镜、窄带成像(NBI)、放大内镜结合窄带成像(ME-NBI)、醋酸-靛胭脂染色内镜、放大内镜联合醋酸-靛胭脂检查,对5种方法的准确性进行比较。结果 134例,共发现150处病变。观察表面微结构方面,ME-NBI(总分503分)与染色放大内镜(总分517分)相似,差异无统计学意义(P＞0.05);观察微血管方面,ME-NBI清晰度(总分495分)明显高于染色放大内镜(总分360分),差异有统计学意义(P＜0.05);显示病灶轮廓方面,ME-NBI(总分485分)与染色放大内镜(总分473分)相似,染色内镜(总分433分)与NBI(总分456分)相似,差异无统计学意义(P＞0.05),均高于普通白光内镜(总分369分),差异有统计学意义(P＜0.05);ME-NBI内镜诊断结果与病理结果具有极高一致性,kappa值为0.845,普通白光内镜、窄带成像、ME-NBI、醋酸-靛胭脂染色内镜、放大内镜联合醋酸-靛胭脂诊断准确率分别为80.7%(121/150)、86.7%(130/150)、94.0%(141/150)、87.3%(131/150)、90.0%(135/150),差异有统计学意义(P＜0.05),常规白光内镜准确率较低。结论 ME-NBI可以提高早期胃癌及癌前病变的检出率,并为下一步治疗提供指导。 |
| 英文摘要: |
| Objective To evaluate the value of magnifying endoscopy combined with NBI,acetic acid added to indigo carmine staining in the diagnosis of gastric mucosal lesion.Methods A total of 134 patients with suspected early gastric cancer were collected from September 2015 to December 2016 in the Second People--s Hospital of Wuhu.The lesions were observed under WLE,NBI,ME-NBI,chromoendoscopy,ME-chromoendoscopy.Calculate the specificity,sensitivity,positive predictive value,negative predictive accuracyand consistency of the 5 methods,then compared the accuracy.Results 150 lesions were found in 134 patients.ME-NBI (total score 503) was similar with magnifying chromoendoscopy (total score 517) in observing micro-structure,the difference was not statistically significant (P＞0.05);The scores of ME-NBI (total score 495) were higher than that of the magnifying chromoendoscopy (total score 360) in observing microvascular,the difference was statistically significant (P＜0.05);Show the contours of the lesion:ME-NBI (total score 485) was similar with magnifying chromoendoscopy (total score 473),chromoendoscopy (total score 433) was similar with NBI (total score 456),the difference was not statistically significant(P＞0.05),were higher than WLE (total score 369),the difference was statistically significant(P＜0.05);There was extremely high consistency between endoscopic diagnosis and pathological results with ME-NBI,Kappa value was 0.845.The diagnostic accuracy of WLE,NBI,ME-NBI,chromoendoscopy,ME-chromoendoscopy gastric mucosal lesion was 80.7%(121/150),86.7%(130/150),94.0%(141/150),87.3%(131/150),90.0%(135/150),respectively,the difference was statistically significant(P＜0.05).and the accuracy rate of WLE was low.Conclusion ME-NBI is a useful method for the diagnose of the early gastric cancer. |
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