胡冬梅;汤琪云;薛成俊;夏艳;
HU Dongmei;TANG Qiyun;XUE Chengjun;XIA Yan;Gastroenterology Department of Jianhu County People's Hospital of Yancheng;Gastroenterology Department of Jiangsu People's Hospital;Endoscopy Center of Jianhu County People's Hospital of Yancheng;

• 1:盐城市建湖县人民医院消化科
• 2:江苏省人民医院消化科
• 3:盐城市建湖县人民医院内镜中心

摘要(Abstract)：

目的:比较三种内镜检查对早期食管癌浸润深度的评估效果。方法:取早期食管癌患者78例,分别采用白光内镜、窄带成像放大内镜(分别使用IPCL分型和B分型两种方法)和超声内镜观察病灶浸润深度,采用Kappa值评价白光内镜、放大内镜和超声内镜与术后病理诊断的一致性,比较3种内镜检查对判断病灶浸润深度的准确性。结果:白光内镜(Kappa=0.679)及NBI放大内镜下IPCL分型(Kappa=0.645)与术后病理结果具有中等一致性,放大内镜下B分型与术后病理结果具有良好一致性(Kappa=0.799),超声内镜与病理结果具有较差一致性(Kappa=0.209);NBI放大内镜下B分型对浸润深度判断的准确性最高,其次是NBI放大内镜下IPCL分型及白光内镜,超声内镜的准确性最差。结论:白光内镜在判断早期食管癌浸润深度方面具有较大价值,其次是放大内镜,而超声内镜准确性较差。
Objective: To explore the evaluation of infiltration depth of early esophageal carcinoma by three kinds of endoscopy. Methods: 78 patients with early esophageal carcinoma were treated with white light endoscopy,narrow-band imaging magnification endoscopy( two methods of IPCL type and B type respectively) and ultrasound endoscopy to observe the infiltration depth. The Kappa value was used to evaluate the consistency of white light endoscopy,magnifying endoscopy and ultrasound endoscopy with postoperative pathological diagnosis. The accuracy of three endoscopies in determining the infiltration depth was compared. Results: The classification of IPCL( Kappa = 0. 645) under white light endoscopy( Kappa = 0. 679) and NBI magnification endoscopy was moderately consistent with postoperative pathological results. B classification under magnifying endoscopy is in good agreement with postoperative pathological results( Kappa = 0. 799),and ultrasonic endoscope and pathological result have poor consistency( Kappa = 0. 209). The accuracy of B typing in NBI magnification endoscopy was the highest in determining the infiltration depth. The accuracy of IPCL classification and white light endoscopy under NBI magnification endoscopy as well as endoscopic ultrasonography were the worst.Conclusion: White light endoscopy is of great value in judging the depth of early esophageal cancer,followed by magnification endoscopy,and the accuracy of endoscopic ultrasonography is poor.

关键词(KeyWords)： 食管肿瘤;内窥镜检查;白光内镜;放大内镜;超声内镜;浸润深度
esophageal cancer;endoscopy;white light endoscopy;magnifying endoscopy;endoscopic ultrasonography;infiltration depth

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 胡冬梅;汤琪云;薛成俊;夏艳;
HU Dongmei;TANG Qiyun;XUE Chengjun;XIA Yan;Gastroenterology Department of Jianhu County People's Hospital of Yancheng;Gastroenterology Department of Jiangsu People's Hospital;Endoscopy Center of Jianhu County People's Hospital of Yancheng;

Email:

DOI: 10.19367/j.cnki.1000-2707.2018.01.025

参考文献(References)：

• [1]王蕾,李鹏.早期食管癌及癌前病变的内镜治疗进展[J].首都医科大学学报,2016,37(5):607-610.
• [2]庄璐,马丹.食管癌危险因素研究进展[J].胃肠病学和肝病学杂志,2015,24(9):1141-1145.
• [3]张志宏,李良平,刘晓岗,等.不同内镜方式判断早期食管癌浸润深度准确性的对比研究[J].中华消化内镜杂志,2017,34(1):43-48.
• [4]孙宇,张川,徐红,等.早期食管癌诊断的新方法:高清显微内镜的应用[J].中国老年学杂志,2015,33(21):6309-6310.
• [5]赵娜,田书信,尚国臣,等.窄带成像技术、染色法及超声内镜联合使用对早期食管癌的诊断价值[J].山东医药,2014,46(28):59-61.
• [6]杨珍明,沈磊.蓝激光成像结合放大内镜对早期胃癌及癌前病变的诊断价值[J].中华消化内镜杂志,2017,34(1):24-29.
• [7]郭涛,陆星华,杨爱明,等.增强放大内镜对早期胃癌的诊断价值[J].中华消化内镜杂志,2014,31(7):384-388.
• [8]曹焱,张超.血清癌胚抗原和细胞角蛋白19片段对食管癌患者放疗效果及生存状况的评估[J].中国肿瘤临床与康复,2015,22(11):1284-1287.
• [9]李艳霞,沈磊,于红刚,等.内镜黏膜下剥离术治疗早期食管癌及癌前病变术后延迟性出血的危险因素分析[J].中华消化内镜杂志,2017,34(2):118-121.
• [10]彭春艳,吴龙云,吕瑛,等.早期食管癌及癌前病变内镜黏膜下剥离术后标本切缘阳性的危险因素分析[J].中华消化内镜杂志,2016,33(7):451-457.
• [11]德吉,秦金玉,郭天骄,等.超声内镜在结直肠癌术前分期中的应用[J].四川医学,2015,34(3):261-265.

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