窄带成像技术在诊断上消化道多原发癌中的应用价值

目的探讨窄带成像技术在诊断上消化道多原发癌中的应用价值。方法2010年6月-2011年6月,接受胃镜检查患者2 452例。对检查中发现的可疑病灶分别使用普通白光内镜和窄带成像内镜观察病灶的形态、范围,同时应用放大内镜手动变焦观察黏膜表面腺管开口及微血管形态。对活检病理确诊的癌灶采用超声内镜、腹部CT或手术标本病理进行T分期。结果2 452例患者中检出多原发癌13例,均为同时双原发癌,检出率为0.53%。13例患者中合并早期癌的比例为30.8%(4/13),包括食管原位癌2例,胃黏膜内癌2例。结论早期癌在上消化道多原发癌中并不少见,但病灶隐匿,普通白光内镜检查容易漏诊,NBI可以提高其检出率。

Application of Narrow Band Imaging in Diagnosis for Multiple Primary Cancer of Upper Gastrointestinal Tract

Objective To investigate the value of narrow band imaging in the diagnosis for multiple primary cancer of upper gastrointestinal tract.Methods From June 2010 to June 2011,2 452 patients underwent upper gastrointestinal endoscopy were enrolled into this study.The suspected lesions were screened with both white light and narrow band imaging(NBI)system,and the superficial glandular structure and microvascular pattern were observed by using magnifying endoscopy with NBI.The T staging of carcinoma diagnosed by biopsy sample was evaluated by endoscopic ultrasound,abdominal CT or surgical resection specimen.ResultsThirteen patients(0.53%)had synchronous multiple cancers.Of these 13 cases,4(30.8%)had early cancer,including 2 carcinoma in situ of the esophagus and 2 intramucosal gastric carcinoma.Conclusion Early cancer is not rare in multiple primary cancer of upper gastrointestinal tract,and it is difficult to detect the lesion by using conventional white light endoscopy.NBI can improve the diagnostic yield.