窄带放大内镜对早期胃癌及癌前病变的观察研究

  目的  探讨窄带成像放大内镜技术(NBI-ME)对早期胃癌及癌前病变的诊断价值。  方法  收集2010年3月至2011年3月福建省立医院消化内镜中心检查患者121例(年龄≥40岁), 利用放大内镜观察黏膜腺管开口和微血管形态, 记录分型, 并取组织行病理检查, 将腺管开口和微血管结合病理结果进行分析。  结果  全组121例中, 早期胃癌16例(13.22%)。胃腺管开口形态分析中, 圆点状(A型)、管状(B型)病例中无早期胃癌或进展期胃癌的病例; 绒毛状(C型)共68例, 其中1例为高级别上皮内瘤变; 不规则状(D型)25例, 其中6例为胃癌, 7例为高级别上皮内瘤变; 腺管结构消失(E型)9例, 其中高级别上皮内瘤变4例, 进展期胃癌5例。在微血管形态分析中, 规则型(A型)病例中无早期胃癌或胃癌; 不规则型(B型)病例35例, 其中进展期胃癌8例, 高级别上皮内瘤变7例; 中央部分消失型(C型)11例, 其中进展期胃癌3例, 高级别上皮内瘤变5例。  结论  利用窄带放大内镜观察胃黏膜细微结构可能提高早期胃癌内镜诊断的准确性。 

Observation of Magnifying Endoscopy with Narrow-band Imaging on Early Gastric Cancer and Precancerous Lesions

  Objective  This study evaluates the diagnosis value of early gastric cancer(EGC) and precancerous lesions using magnifying endoscopy with narrow-band imaging(ME-NBI).  Methods  A total of 121 cases were randomly enrolled in this study(age≥40 years).All lesions were observed through ME-NBI, and the type of crypt-opening(CO) and microvascular(MV) were recorded and biopsied.The type of CO and MV were also analyzed in combination with the pathological diagnosis.  Results  1) EGC was used for the diagnosis of 16 patients from the 121 cases(13.22%).2) CO: cancer was not found in the group with types A and B gastric pits.Only 1 case with high grade dysplasia(HGD) was observed in the group with type C pits(68 cases).A total of 6 cases with cancer and 7 with HGD were observed in the type D pits(25 cases), and 5 cancers and 4 HGDs in the type E pits(9 cases).3) MV: cancer was not seen in the type A group.Eight cases with cancer and seven with HGD was observed in the type B group(35 cases), and three cancers and five HGDs in the type C group(11 cases).  Conclusion  ME-NBI is helpful in improving the accuracy of EGC for CO and MV.