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目的:探讨窄带成像放大内镜(NBI-ME)与术后病理组织学诊断在早期胃癌(EGC)及癌前病变(PCL)诊断方面的异同。方法对前来就诊的患者首先行普通白光内镜(WLE)检查,发现可疑病变后切换至NBI-ME模式,仔细观察胃腺管开口和胃黏膜下微血管的形态,做出镜下诊断,所有患者均行内镜下治疗或外科手术治疗。结果 :(1)NBI-ME下病灶处胃腺管开口形态与术后病理诊断之间的差异具有统计学意义(c2=33.89,P<0.05)。(2)NBI-ME下胃黏膜微血管分型与术后病理诊断之间的差异具有统计学意义(c2=51.12,P<0.05)。(3)NBI-ME与术后病理诊断进行一致性检验的Kappa值为0.54(P<0.05),表明NBI-ME诊断与术后病理诊断一致程度一般。结论 :NBI-ME对PCL、EGC的诊断有较高的临床应用价值,但与病理活组织检查结果相比仍存在差异。
Objective: To explore the similarities and differences in the diagnosis of early gastric cancer (EGC) and precancerous lesions (PCL) between narrow-band imaging magnifying endoscopy (NBI-ME) and postoperative pathological diagnosis. Methods The patients were referred to the routine white light endoscopy (WLE) examination. After the suspicious lesion was found, the patients were switched to the NBI-ME mode. The morphology of the gastric duct opening and the submucosal capillaries were carefully observed and all the patients were diagnosed Endoscopic treatment or surgical treatment. Results: (1) There was significant difference between the morphology of open duct and the postoperative pathological diagnosis of NBI-ME lesions (c2 = 33.89, P <0.05). (2) There was significant difference between NBI-ME gastric mucosal microvascular classification and postoperative pathological diagnosis (c2 = 51.12, P <0.05). (3) The Kappa value of consistency test between NBI-ME and postoperative pathological diagnosis was 0.54 (P <0.05), which indicated that the diagnosis of NBI-ME was consistent with the postoperative pathological diagnosis. Conclusion: NBI-ME has high clinical value in the diagnosis of PCL and EGC, but there are still some differences compared with the results of pathological biopsy.