摘要
[目的]分别使用普通白光模式、高清智能染色内镜(FICE)及FICE+卢戈氏碘染色模式对食管病变行内镜观察,比较3种不同模式诊断早期食管癌及癌前病变的临床价值。[方法]选取行上消化道内镜检查的患者9765例,每例依次进行普通白光模式、FICE模式以及FICE+卢戈氏碘染色模式内镜检查,其中发现食管部位病变的患者99例,共检出病变130处。分别记录在3种模式下所发现的食管病变部位、形状、大小,并以活检及手术病理结果作为诊断金标准,比较3种模式对食管早癌和癌前病变的检出率、特异性。[结果]3种模式中FICE+卢戈氏碘染色模式的病变检出率、特异性明显高于普通白光模式,差异有统计学意义(P=0.000);而在食管早癌和癌前病变的检出率上略高于FICE模式,差异无统计学意义(P=0.120);在发现食管高级别内瘤变(食管早癌及重度不典型增生)的特异性方面显著高于普通白光模式以及FICE模式,差异有统计学意义(χ2=4.483,P=0.000;χ2=5.385,P=0.027)。[结论]FICE+卢戈氏碘染色模式能提高癌前病变及食管早癌的检出率,并对高级别内瘤变具有更高检测特异性。
[Objective]To compare the diagnostic value on esophageal lesion by three endoscopic models： white light mode,high-definition intelligent endoscopy （FICE） and high-definition intelligent endoscopy ＋ Lugo staining. [Methods]We retrospectively selected 9 765 patients accepted gastrointestinal endoscopy examination in our hospital endoscopic center during January 2015-October 2016, every patient was examed by white mode,high-definition intelligent staining endoscopy（FICE）mode and FICE ＋ Lugo staining model,in which we found total 99 patients with esophageal lesions. The location, shape, size of the esophageal lesions found by the three endoscopic examinations were recorded. The biopsy and surgical pathology were used as a diagnostic gold standard. The detection rate, sensitivity, specificity of the three modes were com- pared. I-Results]In the three endoscopy mode, the high-definition intelligent endoscopy ＋ Lugo staining showed the highest detection rate, accuracy, specificity, which was significantly higher than the ordinary white light pattern,the difference was statistically significant（P= 0. 000）. The detection rate of early cancer and precancerous lesion was slightly higher than that of HD intelligent endoscopy, the difference was not statistically significant（P = 0. 120）. However, the specificity of intelligent staining endoscopy combined with Lugo staining in esophageal neoplasia（early esophageal and severe atypical hyperplasia）was significantly higher than that of normal white light model and high-definition intelligent endoscopy model, the difference was statistically significant （P = 4. 483, P = 0. 000;P = 5. 385, P = 0. 027）. [Conclusion] Our study suggests that FICE＋ Lugo staining can significantly increase the detective rate on esophageal early cancer and precancerous lesion,especially the specificity on high-grade intraepithelial neoplasm.
作者
汪杰
卫双连
周艳玲
WANG Jie;WEI Shuang-lian;ZHOU Yan-ling(Denpartment of Gastroenterology, the Huangshi Aikang Hospital, Huangshi Hubei 435000, China;Wuhan University of Science and Technology School of Medicine,Wuhan Hubei 430065,China)
出处
《临床消化病杂志》
2018年第3期157-160,共4页
Chinese Journal of Clinical Gastroenterology
基金
湖北省卫生厅资助课题(No:WJ2017 M177)
黄石市卫生和计划生育委员会资助课题(No:EK2016D130099002019)
关键词
食管肿瘤
电子染色内镜
食管早期病变
tumors of esophagus
fujinon intelligent chromoendoscopy
early lesions of the esophagus
