窄带成像放大内镜可能提高分化型胃上皮内肿瘤的诊断准确性：一项可行性研究。

Magnifying endoscopy with narrow-band imaging may improve diagnostic accuracy of differentiated gastric intraepithelial neoplasia: a feasibility study.

机构信息

Department of Gastroenterology, People's Liberation Army General Hospital, Beijing 100853, China.

出版信息

Chin Med J (Engl). 2012 Mar;125(5):728-32.

Abstract

BACKGROUND

Magnifying narrow-band imaging has enabled observation of the mucosal and vascular patterns of gastrointestinal lesions. This study investigated the potential value of magnifying endoscopy with narrow-band imaging for the classification of gastric intraepithelial neoplasia.

METHODS

Seventy-six patients with gastric intraepithelial neoplasia (82 lesions) at People's Liberation Army General Hospital from December 2009 to November 2010 were analyzed. All patients underwent magnifying endoscopy with narrow-band imaging, and their lesions were differentiated into probable low-grade intraepithelial neoplasia or possible high-grade intraepithelial neoplasia on the basis of the imaging features. Pathologic proof was subsequently obtained by endoscopic submucosal dissection in every case. The validity of magnifying endoscopy with narrow-band imaging was calculated, considering histopathology to be the gold standard.

RESULTS

Magnifying endoscopy with narrow-band imaging showed 22 low-grade intraepithelial neoplastic lesions and 60 high-grade intraepithelial neoplastic lesions. Of the 22 low-grade intraepithelial neoplastic lesions, 16 showed the same results on both imaging and pathology. Of the 60 high-grade intraepithelial neoplastic lesions, 53 showed the same results on both imaging and pathology. Thus, the sensitivity of magnifying endoscopy with narrow-band imaging for high-grade intraepithelial neoplasia was 89.83%, which was higher than that for low-grade intraepithelial neoplasia (69.57%). However, the specificity for high-grade intraepithelial neoplasia (69.57%) was lower than that for low-grade intraepithelial neoplasia (89.83%). The overall accuracy of magnifying endoscopy with narrow-band imaging was 84.15%.

CONCLUSIONS

Magnifying endoscopy with narrow-band imaging can distinguish between gastric low- and high-grade intraepithelial neoplasia. It may be a convenient and effective method for the classification of gastric intraepithelial neoplasia.

摘要

背景

放大窄带成像使人们能够观察胃肠道病变的黏膜和血管形态。本研究旨在探讨放大内镜窄带成像在胃上皮内肿瘤分类中的潜在价值。

方法

分析 2009 年 12 月至 2010 年 11 月期间在中国人民解放军总医院经内镜黏膜下剥离术证实的 76 例胃上皮内肿瘤（82 处病灶）患者的资料。所有患者均行放大内镜窄带成像检查，根据图像特征将病变分为低级别上皮内瘤变可能或高级别上皮内瘤变可能。每例患者均经内镜黏膜下剥离术获得病理证实。以病理结果为金标准，计算放大内镜窄带成像的诊断效能。

结果

放大内镜窄带成像显示 22 处低级别上皮内瘤变和 60 处高级别上皮内瘤变。在 22 处低级别上皮内瘤变中，有 16 处与病理结果相同；在 60 处高级别上皮内瘤变中，有 53 处与病理结果相同。因此，放大内镜窄带成像对高级别上皮内瘤变的敏感度为 89.83%，高于对低级别上皮内瘤变的敏感度（69.57%）；但对高级别上皮内瘤变的特异度（69.57%）低于对低级别上皮内瘤变（89.83%）。放大内镜窄带成像的总体准确率为 84.15%。