窄带成像放大内镜预测胃黏膜下癌。
Prediction of submucosal gastric cancer by narrow-band imaging magnifying endoscopy.
机构信息
Department of Gastroenterology, Niigata Prefectural Yoshida Hospital, Niigata, Japan.
Department of Gastroenterology, Niigata Prefectural Yoshida Hospital, Niigata, Japan.
出版信息
Dig Liver Dis. 2014 Feb;46(2):187-90. doi: 10.1016/j.dld.2013.09.003. Epub 2013 Oct 21.
BACKGROUND
The features of gastric submucosal cancer revealed by magnifying endoscopy have not been reported. Aim of our study was to investigate whether magnifying endoscopy could contribute to the diagnosis of submucosal invasion.
PATIENTS AND METHODS
In this prospective, cross-sectional study, 197 lesions of gastric differentiated adenocarcinoma, diagnosed as mucosal cancer by conventional endoscopy, were observed by magnifying endoscopy with narrow-band imaging, paying attention to the presence of a blurry mucosal pattern and an irregular mesh pattern. After endoscopic submucosal dissection, all lesions were examined histologically and the areas of two features were estimated.
RESULTS
Among the lesions examined, 177 were diagnosed histologically as mucosal cancer and 20 as submucosal cancer. Multivariate logistic regression analysis confirmed that a blurry mucosal pattern (odds ratio 12.15, 95% confidence interval 3.45-42.76, p=0.000) and an irregular mesh pattern (22.55, 4.22-120.45, p=0.000) were independent predictors of submucosal invasion.
CONCLUSIONS
Narrow band imaging magnifying endoscopic features are useful for predicting submucosal invasion in gastric cancer.
背景
放大内镜下胃黏膜下癌的特征尚未报道。本研究旨在探讨放大内镜是否有助于诊断黏膜下浸润。
患者与方法
前瞻性、横断面研究纳入 197 例经普通内镜诊断为黏膜癌的胃分化腺癌病灶，应用窄带成像放大内镜观察，注意模糊黏膜模式和不规则网格模式的存在。内镜黏膜下剥离术后，所有病灶均行组织学检查，并评估两种特征的面积。
结果
检查的病灶中，177 例组织学诊断为黏膜癌，20 例为黏膜下癌。多变量逻辑回归分析证实，模糊黏膜模式（优势比 12.15，95%置信区间 3.45-42.76，p=0.000）和不规则网格模式（22.55，4.22-120.45，p=0.000）是黏膜下浸润的独立预测因子。
结论
窄带成像放大内镜特征有助于预测胃癌的黏膜下浸润。
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