窄带成像放大内镜技术对胃粘膜上皮内瘤变诊断价值的研究

Magnifying endoscopy with narrow-band imaging for may improve diagnostic accuracy of different differentiated gastric intraepithelial neoplasia: a feasibility study

Background: Magnifying narrow band imaging has enabled to observe the mucosal and vascular pattern of gastrointestinal lesions. This study is to investigate the potential value of magnifying endoscopy with narrow-band imaging (ME-NBI) for the classification of gastric intraepithelial neoplasia (IN). Method: 76 patients with gastric intraepithelial neoplasia includes 82 lesions in PLA General Hospital from December 2009 to November 2010 were analyzed. All patients underwent ME-NBI were differentiate probably low-grade intraepithelial neoplasia (LIN) from possibly high-grade intraepithelial neoplasia (HIN) on the basis of their imaging features. Later pathologic proof was obtained by endoscopic submucosal dissection (ESD) in every case. Validity of the ME-NBI was calculated considering the histopathology as gold standard. Results: By ME-NBI, there were 22 LIN and 60 HIN. Out of the 22 LIN,16 were imaging LIN and pathology revealed the same results. Among the 60 HIN ,53 were coincidence with pathology results.Thus, the sensitivity of ME-NBI on HIN was 89.83% which is higher than that on LIN (69.57%). While the specificity on HIN (69.57%) was lower than that on LIN (89.83 %). The overall accuracy of the ME-NBI was 84.15%. Conclusions: Magnifying endoscopy with narrow-band imaging (ME-NBI) can distinguish the gastric LIN to HIN. ME-NBI may be a convenient and effective method for the classification of gastric intra-epithelial neoplasia.