The Application Study Of Narrow Band Imaging Technique Combined With Magnified Endoscopy In The Diagnosis Of Early Gastric Cancer Or Precancerous Lesions

Objective: Using conventional endoscopy, narrow band imaging technique(NBI) and chromoendoscopy combined with magnified endoscopy to value the suspicious lesions,and then compare the diagnostic accuracy of NBI combined with magnified endoscopy in early gastric cancer or precancerous lesions with the diagnostic accuracy of chromoendoscopycombined with magnified endoscopy.Methods: We choose patients from those who have taken endoscopic examination in the affiliated Hospital of Yan’an University from December 2013 to December 2014. Among all patients, 115 patients were enrolled in our study, 59 male and 56 female, the age ranges from 35 to 67 years old with the average age is 50.8±14.9 years old. Patients were detected in the following order:conventional endoscopy→conventional endoscopy+magnified endoscopy→NBI→NBI+magnified endoscopy→chromoendoscopy→chromoendoscopy+magnified endoscopy.In the end, comparsions were taken among conventional endoscopy, NBI and chromoendoscopy or combined with magnified endoscopy by reference to histopathology to determine which technique has the highest diagnostic accuracy.Results: According to the final pathology results, 11 lesions have been finally confirmed as Early Gastric Cancer among these 115 patients. Among these lesions 2lesions are restricted to mucosa layer while 3 are submucosal cancer. Among these lesions, 1 lesions is referred to type I,1 lesions is referred to type IIa, 3 lesions are referred to type IIc, No lesions are referred to type III andtype IIb.3 are moderately differented adenocarcinoma while 2 are poorly differented adenocarcinoma. No lesions are detected by lymph node metastasis. In the rest 110 lesions, 15 lesions are chronic atrophic gastritis, 52 lesions are gastric ulcer, 8 lesions are gastric polyp, 6 lesions are gastric mucosal astrophy, 17 lesions are intestinal metaplasia, 11 lesions are low grade intraepithelial neoplasia, 1 lesion is advanced gastric carcinoma.In the aspect of sharpness observation in lesion in gastric,NBI and chromoendoscopy are better than conventional endoscopy. In the aspect of sharpness observation in gastric pit, NBI and chromoendoscopy combined with magnified endoscopy are better than conventional endoscopy combined with magnified endoscopy. In the aspect of sharpness observation superficial capillaries in gastric, NBI combined with magnified endoscopy is better than chromoendoscopy and conventional endoscopy combined with magnified endoscopy. The specificity of diagnose intestinal metaplasia by NBI combined with magnified endoscopy is better than others. The diagnostic accordance rate,sensitivity, specificity, positive predictive value, negative predictive value, Youden index, false positive rate and false negative rate of NBI are 98.26%、80.00%、99.10%、 80.00%、99.10%、0.79、0.90% and 20.00%, separately. The diagnostic accordance rate, sensitivity, specificity, positive predictive value, negative predictive value, Youden index, false positive rate and false negative rate of chromoendoscopy are 95.65%、50.00%、98.17%, 60.00%、97.27%、0.48、1.83% and 50.00%, separately.Conclusion:The diagnosis of Early Gastric Cancer by NBI is better than chromoendoscopy.It could be considered that NBI system is a complementary technique and it will have a wider prospect of application in the future.