| 摘要: |
| 目的:早期食管癌的及时诊断对提高患者生存率和生活质量至关重要。传统病理活检存在取样误差等局限性,而内镜技术可提供更直观的诊断信息。本研究旨在比较细胞内镜(EC)和放大内镜联合窄带成像(ME-NBI)在早期食管癌诊断中与病理活检结果的一致性。方法:研究为单中心、前瞻性、双盲随机对照试验,纳入2022年6月至2025年4月在沧州市人民医院内镜中心接受白光内镜检查并发现食管黏膜可疑病变的患者,共180例。按1:1比例随机分为EC组(n=94)和ME-NBI组(n=86)。记录并比较两组的诊断结果与病理活检的一致性。结果:EC组总符合率为88.3%,显著高于ME-NBI组的77.9%(P=0.042),Kappa值分别为0.82和0.68。EC在微小病变(≤1cm)的诊断中符合率为90.0%,显著高于ME-NBI组的70.8%(P=0.042)。而ME-NBI对深层浸润(sm3)的判断更可靠(Kappa=0.87 vs. 0.82)。结论:细胞内镜在早期食管癌诊断中与病理活检结果的一致性显著优于ME-NBI,尤其在微小病变诊断中表现突出。两种技术互补,联合应用可提升诊断准确性。 |
| 关键词: 细胞内镜 放大内镜 窄带成像 早期食管癌 病理活检一致性 |
| DOI： |
| 分类号: |
| 基金项目:河北省医学科学研究课题计划资助（20241639） |
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| A Consistency Analysis of Early Esophageal Cancer Diagnosis Using Endocytoscopy and Magnifying Endoscopy with NBI Compared to Pathological Biopsy Results |
|
周杨
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Cangzhou People’s Hospital
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| Abstract: |
| Objective: Early diagnosis of esophageal cancer is critical for improving patients" survival rates and quality of life. Traditional pathological biopsies have limitations such as sampling errors, while endoscopic techniques offer more intuitive diagnostic information. This study compared the consistency of endocytoscopy (EC) and magnifying endoscopy with narrow-band imaging (ME-NBI) with pathological biopsy results in early esophageal cancer diagnosis. Methods: This single-center, prospective, double-blind randomized controlled trial included 180 patients with suspected esophageal lesions detected by white-light endoscopy (WLE) at the Endoscopy Center of Cangzhou People"s Hospital between June 2022 and April 2025. Patients were randomly assigned to EC (n=94) and ME-NBI (n=86) groups. Diagnostic results from both groups were compared to pathological biopsy results. Results: EC showed a total consistency rate of 88.3%, significantly higher than ME-NBI"s 77.9% (P=0.042), with Kappa values of 0.82 and 0.68, respectively. EC achieved a 90.0% consistency rate for small lesions (≤1cm), compared to ME-NBI"s 70.8% (P=0.042). ME-NBI was more reliable for deep infiltration (sm3) assessment (Kappa=0.87 vs. EC"s 0.82). Conclusion: EC demonstrates significantly higher consistency with pathological biopsy results in early esophageal cancer diagnosis than ME-NBI, particularly for small lesions. The two techniques are complementary, and their combined use can enhance diagnostic accuracy. |
| Key words: Endocytoscopy Magnifying endoscopy Narrow-band imaging Early esophageal cancer Pathological biopsy consistency |
