Division of Gastroenterology and Hepatology, Shanghai Jiao-Tong University School of Medicine, Renji Hospital, Shanghai Institute of Digestive Disease, Shanghai Jiao-Tong University, Shanghai, China.
Gastrointest Endosc. 2012 Dec;76(6):1124-32. doi: 10.1016/j.gie.2012.08.015. Epub 2012 Sep 29.
Magnifying endoscopy with narrow-band imaging (ME-NBI) can more clearly assess the surface pattern and microvascular architecture of gastric lesions.
To evaluate the diagnostic efficacy of ME-NBI in patients with early gastric cancer.
Prospective study.
Single academic center.
This study involved 164 suspected gastric lesions in 146 consecutive patients who underwent ME-NBI for additional differential diagnosis before treatment.
ME-NBI findings were classified into 3 groups based on irregularities, absence of surface pattern, and microvascular architecture. All lesions were treated endoscopically or surgically, and ME-NBI diagnosis was compared with histopathological findings.
Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of real-time ME-NBI diagnosis were determined.
The sensitivity, specificity, and accuracy of ME-NBI were 97.3%, 84.4%, and 90.2%, respectively, in distinguishing between cancerous and noncancerous lesions and were 92.3%, 89.7%, and 90.4%, respectively, in distinguishing undifferentiated from differentiated adenocarcinoma. ME-NBI accurately predicted depth of invasion in 37 of 39 differentiated adenocarcinomas (95%).
The sample size was relatively small.
ME-NBI can successfully distinguish between cancerous and noncancerous lesions and between undifferentiated and differentiated adenocarcinomas. Of the 3 patterns on ME-NBI, type A is mainly characteristic of noncancerous lesions, type B is a good indicator of differentiated adenocarcinoma and intramucosal/superficially invasive cancers, and type C is indicative of undifferentiated adenocarcinoma or differentiated cancer with deep submucosal invasion.
窄带成像放大内镜（ME-NBI）可以更清晰地评估胃病变的表面形态和微血管结构。
评估 ME-NBI 对早期胃癌的诊断效能。
前瞻性研究。
单学术中心。
本研究纳入了 146 例连续患者的 164 个疑似胃病变，这些患者在治疗前接受 ME-NBI 进行额外的鉴别诊断。
根据不规则性、表面形态缺失和微血管结构，将 ME-NBI 结果分为 3 组。所有病变均行内镜或手术治疗，并将 ME-NBI 诊断与组织病理学结果进行比较。
实时 ME-NBI 诊断的敏感性、特异性、阳性预测值、阴性预测值和准确性。
ME-NBI 鉴别癌性和非癌性病变的敏感性、特异性和准确性分别为 97.3%、84.4%和 90.2%，鉴别未分化和分化腺癌的敏感性、特异性和准确性分别为 92.3%、89.7%和 90.4%。ME-NBI 准确预测了 39 例分化腺癌中 37 例（95%）的浸润深度。
样本量相对较小。
ME-NBI 能够成功区分癌性和非癌性病变以及未分化和分化腺癌。在 ME-NBI 的 3 种形态中，A型主要特征是非癌性病变，B 型是分化腺癌和黏膜内/浅层浸润癌的良好指标，C 型提示未分化腺癌或分化腺癌伴深黏膜下浸润。
