摘要
目的:探讨内管窄带成像(NBI)技术在早期食管癌及癌前病变诊断中的临床应用价值。方法:回顾性分析我院2016年1月至2018年1月收治的100例拟诊断为早期食管癌患者的临床资料,所有患者均经病理学、常规内镜、NBI以及碘染色检查,以病理学检查结果为金标准,评价3种检查方法的灵敏度、特异度、阳(阴)性预测值和Kappa值(一致性);进行NBI分级及碘染色分级,分析NBI分级及碘染色分级与病理学结果的相关性。结果:100例患者中共发现136个病变,经病理学证实,早期食管癌28处,高级别上皮内瘤变40处,低级别上皮内瘤变38处,共计106处,余下30处为黏膜炎症。内镜NBI的灵敏度为0.802,常规内镜检查的灵敏度为0.745,碘染色的灵敏度为0.896;早期食管癌和高级别上皮内瘤变主要表现为NBIⅠ级,碘染色Ⅰ级,低级别上皮内瘤变在NBI模式下表现为Ⅱ、Ⅲ级,碘染色表现为Ⅱ、Ⅲ级,两种方法的诊断结果差异无统计学意义(P>0.05)。结论:与常规内镜检查比较,内镜NBI模式对于早期食管癌及癌前病变具有较高的诊断率,且NBI分级及碘染色分级与病理学结果具有较好的一致性。
Objective:To investigate the clinical value of narrow-tube imaging(NBI) in the diagnosis of early esophageal cancer and precancerous lesions.Methods:The clinical data of 100 patients with early esophageal cancer who were admitted to our hospital from January 2016 to January 2018 were retrospectively analyzed.All patients were examined by pathology,routine endoscopy,NBI and iodine staining.The pathological examination results were gold standard,and the sensitivity,specificity,positive(positive) and Kappa values(consistency) of the three examination methods were evaluated.NBI classification and iodine staining were performed,NBI classification and iodine staining and correlation of pathological findings were analyzed.Results:A total of 136 lesions were found in 100 cases.Pathologically,there were 28 early esophageal cancers,40 high-grade intraepithelial neoplasias,38low-grade intraepithelial neoplasias,a total of 106,and the remaining 30 were mucosal inflammation.Endoscopy NBI had a sensitivity of 0.802,conventional endoscopy had a sensitivity of 0.745,and iodine staining had a sensitivity of 0.896.Early esophageal cancer and high-grade intraepithelial neoplasia were mainly NBI Ⅰ grade,iodine staining gradeⅠ,and low grade intraepithelial neoplasia.The changes were in grades Ⅱ and Ⅲ in NBI mode,and the levels of iodine staining were grade Ⅱ and Ⅲ.The diagnostic results of the two methods were similar(P>0.05).Conclusion:Compared with conventional endoscopy,endoscopic NBI mode has a high diagnostic rate for early esophageal cancer and precancerous lesions,and NBI grade and iodine staining grade have good consistency with pathological results.
作者
何应碧
HE Yingbi(Department of Digestive Endoscopy,The Second People's Hospital of Jiaozuo City, Jiaozuo 454001,China)
出处
《华夏医学》
CAS
2018年第6期83-87,共5页
Acta Medicinae Sinica
关键词
内管窄带成像技术
早期食管癌
碘染色
narrow-tube imaging technique
early esophageal cancer
iodine staining
