蓝激光成像结合放大内镜与窄带成像放大内镜对上消化道早癌的诊断价值

王于梅; 周智航; 唐尚军; 邓磊; 何松

doi:10.16016/j.1000-5404.201904008

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蓝激光成像结合放大内镜与窄带成像放大内镜对上消化道早癌的诊断价值

临床医学 | 更新时间：2026-01-09

- 蓝激光成像结合放大内镜与窄带成像放大内镜对上消化道早癌的诊断价值
- Diagnostic value of magnifying endoscopy with blue laser imaging versus narrow band imaging for early upper gastrointestinal cancer
- 第三军医大学学报 2019年41卷第18期页码：1789-1795
- 作者机构：
  
  1.400010 重庆，重庆医科大学附属第二医院消化内科
  2.409099 重庆黔江，重庆市黔江中心医院消化内科
- 作者简介：
  
  [ 何松，E-mail:578673595@qq.com HE Song, E-mail: 578673595@qq.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201904008
  中图分类号： R197.39;R730.49;R735
- 收稿：2019-04-01，
  
  修回：2019-07-04，
  
  纸质出版：2019-09-30
- 稿件说明：
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王于梅, 周智航, 唐尚军, 等. 蓝激光成像结合放大内镜与窄带成像放大内镜对上消化道早癌的诊断价值[J]. 第三军医大学学报, 2019,41(18):1789-1795.

Yumei WANG, Zhihang ZHOU, Shangjun TANG, et al. Diagnostic value of magnifying endoscopy with blue laser imaging versus narrow band imaging for early upper gastrointestinal cancer[J]. Journal of Third Military Medical University, 2019, 41(18): 1789-1795.
王于梅, 周智航, 唐尚军, 等. 蓝激光成像结合放大内镜与窄带成像放大内镜对上消化道早癌的诊断价值[J]. 第三军医大学学报, 2019,41(18):1789-1795. DOI： 10.16016/j.1000-5404.201904008.

Yumei WANG, Zhihang ZHOU, Shangjun TANG, et al. Diagnostic value of magnifying endoscopy with blue laser imaging versus narrow band imaging for early upper gastrointestinal cancer[J]. Journal of Third Military Medical University, 2019, 41(18): 1789-1795. DOI： 10.16016/j.1000-5404.201904008.

摘要

目的

比较蓝激光成像放大内镜结合技术与窄带成像放大内镜技术对上消化道早癌的诊断价值。

方法

收集重庆医科大学附属第二医院2017年12月至2018年6月行普通白光内镜(white light endoscopy，WLE)筛查出的可疑上消化道早癌患者466例，共计病灶472处，其中227例采用蓝激光成像放大内镜技术(magnifying endoscopy with blue laser imaging，BLI-ME)、239例采用窄带成像放大内镜技术(magnifying endoscopy with narrowband imaging，NBI-ME)分别进行早癌精查，病检确诊及内镜下高度怀疑早癌的患者均行内镜黏膜下剥离术(endoscopic submucosal dissection，ESD)，最终以ESD术后病理为最高诊断。采用Kappa一致性检验评价BLI-ME、NBI-ME两种内镜诊断与病理诊断的一致性，比较两种检查技术对上消化道早癌的检出率、敏感度、特异度。

结果

病理结果显示炎症269处，萎缩或肠化生127处，低级别上皮内瘤变17处，早癌59处，存在食管多中心癌。BLI-ME、NBI-ME镜下诊断与病理诊断一致的病灶分别为85.2%、85.1%，Kappa值分别为0.756和0.759。BLI-ME、NBI-ME对诊断上消化道早癌的检出率分别为12.2%、12.8%；敏感度分别为89.3%、90.3%；特异度分别为97.0%、96.2%。BLI-ME、NBI-ME镜下诊断与早癌病理诊断一致的比例为96.1%和95.5%，Kappa值分别为0.810和0.825。

结论

BLI-ME、NBI-ME对上消化道早癌的诊断价值较高，且二者的诊断价值相当。

Abstract

Objective

To compare the diagnostic performance of magnifying endoscopy with blue laser imaging (BLI-ME) versus narrowband imaging (NBI-ME) for early upper gastrointestinal cancer.

Methods

This study was carried out among 466 patients with suspected early upper gastrointestinal cancer (472 lesions) screened by conventional white light endoscopy (WLE). Among these patients

227 received subsequent examinations by BLI-ME and 239 were examined by NBI-ME. Endoscopic submucosal dissection (ESD) was performed in all the patients with confirmed cancers or highly suspected early cancer under endoscopy. The definite diagnoses were established according to the pathological results following ESD. The consistency between the endoscopic and pathological diagnoses was evaluated using Kappa agreement test

and the detection rate

sensitivity and specificity of the 2 techniques for diagnosis of early upper gastrointestinal cancer were analyzed.

Results

The pathological results confirmed 269 inflammatory lesions

127 lesions of atrophy or intestinal metaplasia

17 lesions of low-grade intraepithelial neoplasia

and 59 lesions of early cancers (with multicentric esophageal cancer). BLI-ME and NBI-ME had consistency rates of 85.2% and 85.1% with the pathological diagnoses

with Kappa values of 0.756 and 0.759

respectively. For early upper gastrointestinal cancer

the detection rates by BLI-ME and NBI-ME was 12.2% and 12.8%

respectively

and their diagnostic sensitivity was 89.3% and 90.3% with a diagnostic specificity of 97.0% and 96.2%

a consistency rate (with the pathological results) of 96.1% and 95.5%

and a Kappa value of 0.810 and 0.825

respectively.

Conclusion

Both BLI-ME and NBI-ME have high diagnostic value for upper gastrointestinal cancer with comparable diagnostic performances.

关键词

Keywords

references

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