Magnifying endoscopy with narrow-band imaging is useful in the differential diagnosis between low-grade adenoma and early cancer of superficial elevated gastric lesions
Magnifying endoscopy with narrow-band imaging is useful in the differential diagnosis between low-grade adenoma and early cancer of superficial elevated gastric lesions
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DOI：
10.1007/s10120-012-0160-7
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发表时间：
2013-04-01
期刊：
影响因子：
7.4
通讯作者：
Iwashita, Akinori
中科院分区：
文献类型：
--
作者：
Maki, Shinichiro;Yao, Kenshi;Iwashita, Akinori
放大胃镜在鉴别良性和恶性胃粘膜病变方面的作用已被报道。然而，窄带放大内镜（M-NBI）在胃浅表性（非息肉样）升高病变诊断中的应用尚无相关研究。在这项研究中，我们研究了M-NBI在胃浅表升高病变中区分癌症和腺瘤的能力。我们检查了93个连续的胃部浅表升高病变。我们使用常规白光成像（C-WLI）将早期癌症的内镜标准定义为红色，使用M-NBI将不规则微血管模式定义为分界线，或不规则微表面模式定义为分界线。我们测定了C-WLI和M-NBI对这93个病变诊断的敏感性、特异性和准确性。C-WLI与M-NBI的敏感性、特异性和准确性（95%置信区间）分别为64%（52- 76%）对95%(90- 100%),94%（86- 100%）对88%(77- 99%),74%（66- 83%）对92%（86- 98%）。M-NBI的敏感性和准确性显著高于C-WLI。M-NBI在区分胃的癌性和腺瘤性浅表升高病变方面似乎是有用的。
The usefulness of magnifying gastroscopy has been reported in differentiating between benign and malignant gastric mucosal lesions. However, there have been no studies of the usefulness of magnifying endoscopy with narrow-band imaging (M-NBI) in the diagnosis of superficial (non-polypoid) elevated lesions of the stomach. In this study, we investigated the ability of M-NBI to differentiate between cancer and adenoma in superficial elevated lesions of the stomach.We examined 93 consecutive superficial elevated lesions of the stomach. We defined the endoscopic criteria for early cancer as red coloring using conventional white light imaging (C-WLI), and an irregular microvascular pattern with a demarcation line, or irregular microsurface pattern with a demarcation line, using M-NBI. We determined the sensitivity, specificity and accuracy of C-WLI and M-NBI in the diagnosis of these 93 lesions.The sensitivity, specificity, and accuracy (95 % confidence interval) of C-WLI versus M-NBI were 64 % (52-76 %) versus 95 % (90-100 %), 94 % (86-100 %) versus 88 % (77-99 %), and 74 % (66-83 %) versus 92 % (86-98 %), respectively. Sensitivity and accuracy were significantly higher for M-NBI than C-WLI.M-NBI appears to be useful in differentiating between cancerous and adenomatous superficial elevated lesions of the stomach.