摘要
目的:研究亚甲蓝色素内镜在早期胃癌癌前病变诊断中的价值。方法:选择2017年1-9月本院收治的96例疑似早期胃癌癌前病变患者为研究对象,所有患者分别进行亚甲蓝色素内镜和普通内镜检查。观察亚甲蓝色素内镜和普通内镜的检查结果,分析两种检查方式与病理检查的一致性,并比较两种内镜图像清晰度评分情况。结果:亚甲蓝色素内镜检查诊断58例患者为癌前病变,准确率为85.42%、灵敏度为86.67%、特异度为83.33%、阳性预测值为89.66%、阴性预测值为78.95%、Kappa值为0.692。普通内镜检查诊断早期胃癌癌前病变准确率为48.96%、灵敏度为41.67%、特异度为61.11%、阳性预测值为64.10%、阴性预测值为38.60%、Kappa值为0.025。亚甲蓝色素内镜对炎性伴肠化、不典型增生的正确检出率均显著高于普通内镜,差异均有统计学意义(P<0.05)。亚甲蓝色素内镜图像清晰度评分为1、2分的患者例数均显著少于普通内镜,评分为3、4分的患者例数均显著多于普通内镜,差异均有统计学意义(P<0.05)。结论:亚甲蓝色素内镜能够提高对早期胃癌癌前病变的诊断率,且内镜图像清晰度较高,具有较高的临床应用价值。
Objective:To study the value of methylene blue endoscopy in the diagnosis of precancerous lesions of early gastric cancer.Method:A total of 96 patients with suspected precancerous lesions of early gastric cancer admitted to our hospital from January to September 2017 were selected as the study subjects,all patients were examined by methylene blue endoscopy and general endoscopy respectively.The results of methylene blue endoscopy and general endoscopy were observed,the consistency between the two examination methods and pathological examination were analyzed,and the two endoscopic image sharpness scores were compared.Result:Fifty-eight patients were diagnosed as precancerous lesions by methylene blue endoscopy,the accuracy was 85.42%,the sensitivity was 86.67%,the specificity was 83.33%,the positive predictive value was 89.66%,the negative predictive value was 78.95%,Kappa value was 0.692.The accuracy of general endoscopy in the diagnosis of precancerous lesions of early gastric cancer was 48.96%,sensitivity was 41.67%,specificity was 61.11%,positive predictive value was 64.10%,negative predictive value was 38.60%,Kappa value was 0.025.The correct detection rate of methylene blue endoscopy for inflammation with intestinal metaplasia and atypical hyperplasia were significantly higher than those of common endoscopy,the differences were statistically significant(P<0.05).The number of patients with methylene blue endoscopic image clarity score of 1 and 2 were significantly less than those of general endoscopy,and the number of patients with score of 3 and 4 were significantly more than those of general endoscopy,the differences were statistically significant(P<0.05).Conclusion:Methylene blue endoscopy can improve the diagnosis rate of precancerous lesions of early gastric cancer,and has a high resolution of endoscopic image,which has a high clinical application value.
作者
冯硕旦
植中敬
谭飞鸥
FENG Shuodan;ZHI Zhongjing;TAN Feiou(Zhaoqing Second People’s Hospital,Zhaoqing 526000,China;不详)
出处
《中国医学创新》
CAS
2020年第21期153-157,共5页
Medical Innovation of China
关键词
亚甲蓝
色素内镜
早期胃癌
癌前病变
Methylene blue
Pigment endoscopy
Early gastric cancer
Precancerous lesions
