建立一个用于诊断胃黏膜相关淋巴组织（MALT）淋巴瘤的内镜诊断流程系统（M 系统）。

Establishing an endoscopic diagnostic process system (M-system) for gastric MALT lymphoma of superficial-spreading type.

机构信息

Department of Gastroenterology, Armed Police Forces Hospital of Sichuan, LeShan 614000, China.

Department of Pathology, Armed Police Forces Hospital of Sichuan, Leshan 614000, China.

出版信息

Jpn J Clin Oncol. 2021 Apr 1;51(4):560-568. doi: 10.1093/jjco/hyaa242.

DOI:10.1093/jjco/hyaa242

PMID:33438732

Abstract

OBJECTIVE

Gastric mucosa-associated lymphoid tissue lymphoma is a rare disease, which is associated with a low endoscopic diagnostic accuracy even on tissue biopsy. We aimed to establish a diagnostic process system (M-system) using detailed magnifying endoscopy images to improve the diagnostic efficiency of this disease.

METHODS

First, 34 cases from 16 patients with the diagnosis of mucosa-associated lymphoid tissue lymphoma were collected as the study group. The control group included randomly selected patients who were diagnosed with early differentiated carcinoma, undifferentiated carcinoma or inflammation. Then, the endoscopic images of these patients were analyzed by senior physicians. Finally, the M-system was established based on the data extracted from the images reviewed, and its diagnostic efficiency for mucosa-associated lymphoid tissue lymphoma was validated by the junior physicians.

RESULTS

A series of elements with high sensitivity and specificity for the diagnosis of mucosa-associated lymphoid tissue lymphoma on endoscopic images were extracted for the establishment of the M-system. Using the M-system, the diagnostic accuracy, sensitivity, specificity and correct indices of mucosa-associated lymphoid tissue lymphoma rose from 65.4 to 79.4%, 41.2 to 76.5%, 73.5 to 80.4% and 0.147 to 0.569%, respectively, all of which were statistically significant.

CONCLUSIONS

The M-system can improve the diagnostic accuracy of mucosa-associated lymphoid tissue lymphoma of the superficial-spreading type on detailed magnifying endoscopy. This would help in the early diagnosis of the disease and treatment, which would translate into improved clinical outcomes.

摘要

目的

胃黏膜相关淋巴组织淋巴瘤是一种罕见疾病，即使在组织活检时，其内镜诊断准确性也较低。我们旨在建立一个使用详细放大内镜图像的诊断流程系统（M 系统），以提高该疾病的诊断效率。

方法

首先，收集了 16 例患者的 34 例经诊断为黏膜相关淋巴组织淋巴瘤的病例作为研究组。对照组包括随机选择的被诊断为早期分化癌、未分化癌或炎症的患者。然后，由资深医生对这些患者的内镜图像进行分析。最后，根据对审查图像提取的数据建立了 M 系统，并由初级医生验证其对黏膜相关淋巴组织淋巴瘤的诊断效率。

结果

为建立 M 系统，提取了一系列在放大内镜图像上对黏膜相关淋巴组织淋巴瘤诊断具有高灵敏度和特异性的特征元素。使用 M 系统，黏膜相关淋巴组织淋巴瘤的诊断准确性、灵敏度、特异性和正确指数分别从 65.4%、41.2%、73.5%和 0.147 提高到 79.4%、76.5%、80.4%和 0.569%，均具有统计学意义。