Diagnostic value of narrow band imaging and magnifying endoscopy in gastric neuroendocrine neoplasms
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摘要: 目的 分析运用白光内镜(WLI)及放大内镜窄带成像(ME-NBI)诊断胃神经内分泌肿瘤(G-NENs)的特点并探讨其临床诊断价值。方法 选择2017年1月-2021年6月西安市人民医院收治的36例G-NENs患者(观察组)及同期收治的40例胃息肉患者(对照组)临床资料，分析观察组临床病理特点及2组病变ME-NBI特点。结果 WLI结合ME-NBI诊断G-NENs敏感性为80.6%，特异性为90.0%，阳性预测值为87.9%，阴性预测值为83.7%，准确度为85.5%，约登指数为0.71。结论 WLI结合ME-NBI有利于观察G-NENs表面特异性的腺体结构改变及上皮下黑棕色迂曲增粗的螺旋状血管，对于鉴别G-NENs及胃息肉有重要意义，能够针对性地对病灶进行靶向活检，避免漏诊及误诊，并对正确治疗方式选择提供帮助。Abstract: Objective To investigate the values of white light imaging combined with magnifying endoscopy and narrow band imaging(ME-NBI) in the diagnose of the gastric neuroendocrine neoplasms(G-NENs).Methods Clinical data, characteristics of WLI and ME-NBI, pathological and immunehistochemical results of 36 G-NENs patients and 40 gastric polyps patients from January 2017 to June 2021 in our hospital were collected and retrospectively analyzed.Results WLI combined with ME-NBI diagnosis of G-NENs showed that the sensitivity was 80.6%, the specificity was 90.0%, the positive predictive value was 87.9%, the negative predictive value was 83.7%, the accuracy rating was 85.5% and the Yoden index was 0.71.Conclusion WLI combined with ME-NBI has been shown to be more effective for targeting biopsy by discovery specific structural changes and dilated blackish-brown subepithelial vessels with cork-screw capillaries on the surface of G-NENs, has a significant clinical value for diagnosis of G-NEN and differentiation diagnosis of gastric polyps, avoid and reduce the rate of misdiagnose and adapts appropriate treatment strategies.
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表 1 患者基线资料及内镜下特点
类别 观察组(n=36) 对照组(n=40) P 年龄/岁 47.0±3.1 45.0±2.6 0.332 性别(男/女) 16/20 19/21 0.821 胃泌素/(pg·mL-1) 297.2(238.8，408.8) 105.6(59.2，170.9) 0.004 临床症状/例 0.720 腹胀 20 22 腹痛 16 18 WLI/例 色泽发红 30 3 < 0.001 ME-NBI/例 微结构改变 21 0 < 0.001 微血管改变 30 4 < 0.001 
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