智能电子染色内镜在慢性萎缩性胃炎诊断中的应用*

目的：探讨智能电子染色内镜(I-Scan)在慢性萎缩性胃炎(chronic atrophic gastritis, CAG)诊断中的应用。方法：选取2017年3月—2018年11月在南通市第四人民医院行胃镜检查，且初步诊断为慢性胃炎的患者410例，随机分成两组，采用白光内镜检查(白光组)和采用白光和智能电子染色内镜切换检查(I-Scan组)，预判别患者是否有黏膜腺体萎缩，分成阳性组和阴性组，阳性组行靶向活检并详细记录，阴性组在胃窦、胃体小弯及大弯各取1块组织送病理，所得结果与病理组织学结果进行比较分析。结果：白光组202例，病理结果符合CAG 54例，其中预判别符合19例，伴上皮内瘤变3例；I-Scan组208例，病理结果符合CAG 59例，其中预判别符合48例，伴上皮内瘤变8例。白光组的诊断符合率70.30%，敏感性35.19%，特异性83.11%，漏诊率64.81%，误诊率16.89%；I-Scan组诊断符合率87.98%，敏感性81.36%，特异性90.60%，漏诊率18.64%，误诊率9.40%，两组比较差异有统计学意义(P<0.05)。结论：I-Scan对CAG诊断检出率高，同时可指导靶向活检，可用于临床推广。

Application of intelligent electronic staining endoscopy inthe diagnosis of chronic atrophic gastritis*

Objective: To investigate the application of intelligent electronic staining endoscopy(I-Scan) in the diagnosis of chronic atrophic gastritis(CAG). Methods: From March 2017 to November 2018, the endoscopy center of our hospital was selected for gastroscopy. At the same time, 410 patients with preliminary diagnosis of chronic gastritis were randomly divided into two groups for gastroscopy. One group uses white light endoscopy. The another group uses white light and I-Scan switching check.Both groups pre-identified whether the patient had mucosal gland atrophy. And according to the pre-identified result, the patients were divided into a positve group and a negtive group at the same time. The positive group was targeted for biopsy and recorded in detail, the patients in the negative group took a piece of pathology in the antrum of the stomach, small curvature of the stomach and big bend. All results were compared with histopathological results. Results: A total of 202 patients were included in the study. The pathological results were consistent with CAG in 54 cases, of which 19 cases were pre-judging and 3 cases were associated with intraepithelial neoplasia. There were 208 cases in the two groups, and the pathological results were consistent with CAG in 59 cases, of which 48 cases were pre-identified and 8 cases were associated with intraepithelial neoplasia. The diagnosis rate of a group of CAG diagnosis was 70.30%, the sensitivity was 35.19%, the specificity was 83.11%, the missed diagnosis rate was 64.81%, and the misdiagnosis rate was 16.89%. The diagnostic accuracy of the two groups for CAG diagnosis was 87.98%, the sensitivity was 81.36%, the specificity was 90.60%, the missed diagnosis rate was 18.64%, and the misdiagnosis rate was 9.40%. The difference between the two groups was statistically significant. Conclusion: I-Scan has a high detection rate for CAG. At the same time, targeted biopsy can be guided and could be clinically promoted.