窄带成像放大内镜和共聚焦激光显微内镜诊断胃肿瘤性病变的价值(1)
[摘要] 目的 探討窄带成像放大内镜和共聚焦激光显微内镜在诊断胃肿瘤性病变中的价值。 方法 选择2015年1月～2016年12月在我院就诊的疑似胃部恶性病变的患者100例为研究对象。所有患者均行常规白光内镜、窄带成像放大内镜、共聚焦内镜检查。以病理检查结果为金标准，分析窄带成像放大内镜、共聚焦内镜检查敏感度、特异度、阳性预测值、阴性预测值，并分析与病理检查结果的一致性。 结果 窄带成像放大内镜诊断敏感度91.1%；特异度96.3%；阳性预测值93.2%；阴性预测值92.9%。与病理诊断的一致性分析结果显示κ=0.85。共聚焦内镜诊断敏感度91.1%；特异度90.9%；阳性预测值89.1%；阴性预测值92.6%。与病理诊断的一致性分析结果显示κ=0.82。窄带成像放大内镜与共聚焦内镜在诊断胃肿瘤性病变中的敏感度、特异度、阳性预测值以及阴性预测值比较差异无统计学意义(P>0.05)。 结论 窄带成像放大内镜和共聚焦激光显微内镜诊断胃肿瘤性病变与病理结果具有较高的一致性。
[关键词] 窄带成像放大内镜；共聚焦激光显微内镜；胃肿瘤；病理
[中图分类号] R445.9 [文献标识码] A [文章编号] 1673-9701(2017)20-0029-03
[Abstract] Objective To discuss the value of narrow band imaging magnifying endoscope and confocal laser scanning microscopy in the diagnosis of gastric lesions. Methods 100 cases with gastric lesions from Jan 2015 to Dec 2016 were selected as subjects. All cases were detected with conventional white light endoscopy， narrow band imaging magnifying endoscope and confocal laser scanning microscopy. The gold standard was based on the pathological examination results， and sensitivity， specificity， positive predictive value， negative predictive value of narrow band imaging magnifying endoscope and confocal laser scanning microscopy were analyzed. Uniformity was analyzed between the results with pathological examination results. Results Narrow band imaging magnifying endoscope： sensitivity was 91.1%， specificity was 96.3%， positive predictive value was 93.2%， negative predictive value was 92.9%， and the results of uniformity was κ=0.85. Confocal laser scanning microscopy： sensitivity was 91.1%， specificity was 90.9%， positive predictive value was 89.1%， negative predictive value was 92.6%， and the results of uniformity was κ=0.82. The sensitivity， specificity， positive predictive value， negative predictive value of narrow band imaging magnifying endoscope and confocal laser scanning microscopy were compared， the differences were no statistically significant(P>0.05). Conclusion Narrow band imaging magnifying endoscope and confocal laser scanning microscopy in the diagnosis of gastric lesions are with high consistency with pathological examination results.
[Key words] Narrow band imaging magnifying endoscope；Confocal laser scanning microscopy；Gastric lesions；Pathology
胃肿瘤靠临床症状很难确诊，X光钡剂检查可见胃内有边缘整齐的圆形充盈缺损，肿瘤表现有溃疡时可见龛影。但X线钡剂检查并不能鉴别肿瘤的良恶性，尤其更不能发现肿瘤的早期恶变。因此，胃镜的检查尤为重要，可直观观察病灶，能够取标本进行病理学检查[1]。目前临床上出现了窄带成像放大内镜和共聚焦激光显微内镜等新技术，前者能够将胃黏膜表面结构放大数十倍，能够更为清晰地观察病灶[2，3]。共聚焦激光显微内镜将传统实验室桌面使用的共聚焦显微内镜原理运用到内窥镜技术当中，对于某些胃肠道常见疾病，尤其是较小病灶及早期胃肠道肿瘤的诊断具有快速、准确的优势[4，5]。本研究分析窄带成像放大内镜和共聚焦激光显微内镜在诊断胃肿瘤性病变中的价值，现报道如下。, 百拇医药(陈涛)
[关键词] 窄带成像放大内镜；共聚焦激光显微内镜；胃肿瘤；病理
[中图分类号] R445.9 [文献标识码] A [文章编号] 1673-9701(2017)20-0029-03
[Abstract] Objective To discuss the value of narrow band imaging magnifying endoscope and confocal laser scanning microscopy in the diagnosis of gastric lesions. Methods 100 cases with gastric lesions from Jan 2015 to Dec 2016 were selected as subjects. All cases were detected with conventional white light endoscopy， narrow band imaging magnifying endoscope and confocal laser scanning microscopy. The gold standard was based on the pathological examination results， and sensitivity， specificity， positive predictive value， negative predictive value of narrow band imaging magnifying endoscope and confocal laser scanning microscopy were analyzed. Uniformity was analyzed between the results with pathological examination results. Results Narrow band imaging magnifying endoscope： sensitivity was 91.1%， specificity was 96.3%， positive predictive value was 93.2%， negative predictive value was 92.9%， and the results of uniformity was κ=0.85. Confocal laser scanning microscopy： sensitivity was 91.1%， specificity was 90.9%， positive predictive value was 89.1%， negative predictive value was 92.6%， and the results of uniformity was κ=0.82. The sensitivity， specificity， positive predictive value， negative predictive value of narrow band imaging magnifying endoscope and confocal laser scanning microscopy were compared， the differences were no statistically significant(P>0.05). Conclusion Narrow band imaging magnifying endoscope and confocal laser scanning microscopy in the diagnosis of gastric lesions are with high consistency with pathological examination results.
[Key words] Narrow band imaging magnifying endoscope；Confocal laser scanning microscopy；Gastric lesions；Pathology
胃肿瘤靠临床症状很难确诊，X光钡剂检查可见胃内有边缘整齐的圆形充盈缺损，肿瘤表现有溃疡时可见龛影。但X线钡剂检查并不能鉴别肿瘤的良恶性，尤其更不能发现肿瘤的早期恶变。因此，胃镜的检查尤为重要，可直观观察病灶，能够取标本进行病理学检查[1]。目前临床上出现了窄带成像放大内镜和共聚焦激光显微内镜等新技术，前者能够将胃黏膜表面结构放大数十倍，能够更为清晰地观察病灶[2，3]。共聚焦激光显微内镜将传统实验室桌面使用的共聚焦显微内镜原理运用到内窥镜技术当中，对于某些胃肠道常见疾病，尤其是较小病灶及早期胃肠道肿瘤的诊断具有快速、准确的优势[4，5]。本研究分析窄带成像放大内镜和共聚焦激光显微内镜在诊断胃肿瘤性病变中的价值，现报道如下。, 百拇医药(陈涛)