经超细经鼻内镜窄带成像筛查食管病变。
Narrow-band imaging on screening of esophageal lesions using an ultrathin transnasal endoscopy.
机构信息
Endoscopy Centre, Tokyo Medical University Hospital, Tokyo Medical University, Tokyo, Japan.
出版信息
J Gastroenterol Hepatol. 2012 Apr;27 Suppl 3:34-9. doi: 10.1111/j.1440-1746.2012.07068.x.
BACKGROUND AND AIM
Ultrathin transnasal endoscopy, used extensively in Japan, is considered to have inferior image quality and suction performance, and questionable diagnostic performance. So the aim of the present study was to compare the diagnostic performance of white light (WL) examination and non-magnified narrow-band imaging (NBI) examination in screening for esophageal disorders with ultrathin transnasal endoscopy.
METHODS
A prospective case study of 105 consecutive patients screened for upper gastrointestinal disorders at a single clinic in Tokyo Medical University Hospital. All subjects were diagnosed using WL, NBI and Lugol-staining examinations. Areas ≥ 5 mm clearly not a Lugol-staining lesion were defined as esophageal disorders and the rates of detection of the two examination methods (WL vs NBI) were compared.
RESULTS
For WL examination, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy (concordance rate) for esophageal disorders were 19.6%, 98.1%, 90.9%, 55.4%, and 59.2%, respectively, versus 60.8% 96.2%, 93.9%, 71.4%, and 78.6% for NBI.
CONCLUSION
A useful level of diagnostic performance for esophageal disorders can be achieved with non-magnified narrow-band NBI ultrathin transnasal endoscopy.
背景与目的
在日本广泛应用的超细经鼻内镜，被认为其图像质量和抽吸性能较差，诊断性能也值得怀疑。因此，本研究旨在比较白光（WL）检查和非放大窄带成像（NBI）检查在超细经鼻内镜筛查食管疾病中的诊断性能。
方法
在东京医科大学医院的一家诊所，对 105 例连续接受上消化道疾病筛查的患者进行前瞻性病例研究。所有患者均接受 WL、NBI 和卢戈氏染色检查进行诊断。将直径≥5mm、明显无卢戈氏染色病变的区域定义为食管病变，并比较两种检查方法（WL 与 NBI）的检出率。
结果
对于 WL 检查，食管病变的灵敏度、特异性、阳性预测值、阴性预测值和诊断准确性（一致性率）分别为 19.6%、98.1%、90.9%、55.4%和 59.2%，而 NBI 检查则分别为 60.8%、96.2%、93.9%、71.4%和 78.6%。
结论
非放大窄带 NBI 超细经鼻内镜可实现食管疾病的诊断性能。
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