醋酸染色联合窄带成像对胃黏膜肠上皮化生的诊断价值

目的:探讨内镜醋酸染色联合窄带成像模式对幽门螺杆菌阳性患者胃黏膜肠上皮化生(gastric intestinal metaplasia,GIM)病灶的诊断效果以及在筛查中的价值。方法:对93例幽门螺旋杆菌感染患者进行胃镜检查,分别在常规白光(esophagogastroduodenoscopy,EGD)、醋酸染色(acetic acid chromoendoscopy,ACC)、ACC联合窄带成像(narrow band imaging,NBI)3种模式下进行观察诊断并活检,比较3种模式下对GIM的诊断效果。结果:ACC+NBI模式的灵敏度为92.06%,远高于ACC模式的74.60%及EGD模式的30.16%,差别有统计学意义(P<0.05),3种模式的特异度差别无统计学意义(P>0.05)。EGD、ACC、ACC+NBI模式的ROC曲线AUC分别为0.584、0.790、0.860。结论:ACC联合NBI模式能明显提高内镜下胃黏膜GIM的诊断,是胃黏膜GIM筛查的良好工具。

Diagnostic value of acetic acid chromoendoscopy combined with narrow-band imaging in gastric intestinal metaplasia

Objective: To investigate the diagnostic effect and value in acetic acid chromoendoscopy combined with narrow-band imaging mode for gastric intestinal metaplasia (GIM) in Helicobacter pylori positive patients. Methods: Ninety-three patients with Helicobacter pylori infection were examined by endoscopy. They were observed and biopsied by esophagogastroduodenoscopy (EGD) mode, acetic acid chromoendoscopy (ACC) mode, and ACC combined with narrow-band imaging(NBI)mode. The diagnostic effects of the three models for GIM were calculated. Results: The diagnostic sensitivity of ACC combined with NBI mode for GIM was 92.06%, much higher than that of ACC 74.60% and EGD 30.16%. The AUC of three models was 0.584, 0.790 and 0.860 respectively. Conclusions: ACC combined with NBI can significantly improve the diagnosis of GIM, and might be a good tool for GIM screening.