窄带成像放大内镜靶向活检在胃黏膜肠上皮化生中的临床运用

目的：探讨窄带成像放大内镜（ magnifying endoscopy with narrow-band imaging NBI-ME）下胃黏膜肠上皮化生（ intestinal metaplasia IM）的形态学特征，并结合病理学探讨NBI-ME下靶向活检诊断IM的临床运用。方法对50例患者行常规检查，窄带成像放大内镜（ NBI-ME）观察胃体有无浅蓝色的嵴状结构（ light blue crest LBC）、边缘透光带（ marginal turbid band MTB）区域，分别在LBC、MTB区域或阴性区域活检，并对病理结果进行比较分析。结果50例患者中，共获得112块活检组织，其中88块组织取自MTB＋区域，其中病理学诊断IM：68例，灵敏度：97．1％，特异度：52．3％；24块组织取自LBC＋区域，其中病理学诊断IM：22例，灵敏度：31．4％，特异度：95．2％；MTB＋／LBC＋区域重度IM比例最高．NBI-ME下在LBC、MTB阳性黏膜区活检可明显提高IM的检出率（P＜O．05）。结论 NBI-ME对MTB、LBC区域靶向活检，提高IM的检出率，对胃癌的早期发现、早期诊断、早期治疗有重要的意义。

The clinical application of magnifying endoscopy with narrow-band imaging(ME-NBI) in targeted-biopsy of intestinal metaplasla

Objective To investigate the morphologic features of gastric intestinal metaplasia (IM) using magnifying endoscopy with narrow-band imaging( ME-NBI) and its clinical use in the diagnosis of IM under ME-NBI targeted biopsy.Methods The endoscopic examination was performed on 50 patients and suspected lesions of gastric body associated with IM were further observed by ME-NBI. The biopsy specimens were obtained from regions containing light blue crest ( LBC) ,marginal turbid band ( MTB ) mucosa or normal area for pathological examination, and the results were analyzed.Results In 50 patients examined with ME-NBI, we received 112 pieces of biopsy samples.IM was pathologically confirmed in patients.For the diagnosis of IM,MTB had a sensitivity and specificity of 97.1%and 52.3%,respectively,and the corresponding values for LBC were 31.4%and 95.2%.When groups classified according to the presence or absence of MTB and LBC were compared,severe IM was more commonly seen in MTB+/LBC+areas than in the other two regions.Conclusion It has been demonstrated that NBI–ME can improve the diagnosis of IM by targeted-biopsy in LBC or MTB region,which is helpful in early diagnosis of gastric cancer.