探头式共聚焦激光显微内镜对胃底腺息肉的诊断价值

王梓义; 陈静; 周学谦; 杨佳; 孟祥勇; 吴静; 陈文生

doi:10.16016/j.2097-0927.202310082

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探头式共聚焦激光显微内镜对胃底腺息肉的诊断价值

临床医学 | 更新时间：2026-01-09

- 探头式共聚焦激光显微内镜对胃底腺息肉的诊断价值
- Diagnostic value of probe-based confocal laser microendoscopy in differential diagnosis of fundic gland polyps
- 陆军军医大学学报 2024年46卷第10期页码：1150-1157
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院消化内科
- 作者简介：
  
  [陈文生，E-mail: 2303141134@qq.comCHEN Wensheng, E-mail: 2303141134@qq.com
- 基金信息：
- DOI：10.16016/j.2097-0927.202310082
  中图分类号： R573;R730.49;R735.2
- 收稿：2023-10-22，
  
  修回：2024-01-09，
  
  纸质出版：2024-05-30
- 稿件说明：
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王梓义, 陈静, 周学谦, 等. 探头式共聚焦激光显微内镜对胃底腺息肉的诊断价值[J]. 陆军军医大学学报, 2024,46(10):1150-1157.

Ziyi WANG, Jing CHEN, Xueqian ZHOU, et al. Diagnostic value of probe-based confocal laser microendoscopy in differential diagnosis of fundic gland polyps[J]. Journal of Army Medical University, 2024, 46(10): 1150-1157.
王梓义, 陈静, 周学谦, 等. 探头式共聚焦激光显微内镜对胃底腺息肉的诊断价值[J]. 陆军军医大学学报, 2024,46(10):1150-1157. DOI： 10.16016/j.2097-0927.202310082.

Ziyi WANG, Jing CHEN, Xueqian ZHOU, et al. Diagnostic value of probe-based confocal laser microendoscopy in differential diagnosis of fundic gland polyps[J]. Journal of Army Medical University, 2024, 46(10): 1150-1157. DOI： 10.16016/j.2097-0927.202310082.

摘要

目的

探讨探头式共聚焦激光显微内镜(probe-based confocal laser endomicroscopy，pCLE)在胃底腺息肉诊断中的价值。

方法

纳入2023年6-12月于陆军军医大学第一附属医院消化内科内镜中心行普通白光内镜(white light image，WLI)提示胃息肉患者63例，收集患者临床资料、白光内镜图像、窄带成像内镜(narrow band imaging，NBI)图像、pCLE内镜图像以及术后组织病理，统计验证胃底腺息肉在pCLE内镜下特点，分别计算不同内镜诊断的灵敏度、特异性、准确度、一致性。

结果

胃底腺息肉在pCLE内镜下主要表现为胃小凹开口拉长，“手牵手样”胃小凹开口，小凹开口周围血管规则，无荧光素渗出。WLI的灵敏度、特异度、准确度、一致性分别为：72.73%、75.00%、73.13%、0.343(胃底腺息肉)，81.82%、71.43%、71.64%、0.354(增生性息肉)；NBI的灵敏度、特异度、准确度、一致性分别为87.27%、83.33%、86.57%、0.673(胃底腺息肉)；81.82%、85.71%、85.07%、0.554(增生性息肉)；pCLE的灵敏度、特异度、准确度、一致性分别为92.73%、91.67%、92.53%、0.769(胃底腺息肉)，90.91%、94.64%、94.03%、0.797(增生性息肉)。pCLE的灵敏度、特异度等均优于WLI和NBI，与病理诊断的一致性较好。

结论

pCLE可用于胃底腺息肉的诊断。

Abstract

Objective

To explore the value of probe-based confocal laser endomicroscopy (pCLE) in the differential diagnosis of fundic gland polyps.

Methods

A total of 63 patients who underwent conventional white light image (WLI) and suggested with gastric polyps in our gastroenterology endoscopy center during June and December 2023 were enrolled

and their clinical data

WLI

narrow band images (NBI)

pCLE images and postoperative histopathological findings were collected. The characteristics of fundic gland polyps under pCLE were statistically verified

and the sensitivity

specificity

accuracy and consistency of different endoscopic diagnoses were calculated respectively.

Results

Under pCLE

fundic gland polyps were mainly manifested as elongated gastric pit opening

"hand-in-hand" gastric pit opening

well-arranged blood vessels around the pit opening

and no luciferin oozing. The sensitivity

specificity

accuracy of WLI were 72.73%

75.00%

73.13% and 0.343 for fundic gland polyps

and 81.82%

71.43%

71.64% and 0.354 for hyperplastic polyps

respectively. While

the above values of NBI were 87.27%

83.33%

86.57% and 0.673 for fundic gland polyps

and 81.82%

85.71%

85.07% and 0.554 for hyperplastic polyps; and those of pCLE were 92.73%

91.67%

92.53% and 0.769 for fundic gland polyps

and 90.91%

94.64%

94.03% and 0.797 for hyperplastic polyps pCLE had better sensitivity

specificity and accuracy than WLI and NBI

and had the results consistent with histopathological findings.

Conclusion

pCLE can be used in the differential diagnosis of fundic gland polyps.

关键词

Keywords

references

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