| Background and purposeGastric polyps are protuberant lesions originated from gastric mucosal tissues,with insipid onset and no obvious clinical symptoms.Studies have shown that gastric polyps have certain cancerous potential,and there is no consensus on pathogenesis and risk factors.Therefore,the study on gastric polyps has become a research hotspot in the current field of digestion In recent years,the detection rate of gastric polyps has been increasing at home and abroad,and the clinical characteristics of gastric polyps have also changed accordingly.Different pathological types of gastric polyps have different cancerous potential and treatment principles.How to find gastric polyps under microscope and predict the pathological types of gastric polyps is the hot and difficult research topic at present It is difficult to judge the pathological type of gastric polyps found under ordinary white light endoscopy,and ME-NBI(magnifying endoscopy narrow band)can clearly observe the glandular opening and mucosal microvascular structure of polyps,and help to distinguish different pathological types of polyps.At present,there are few reports on the study of the microscopic characteristics of gastric polyps by high-definition endoscopy combined with narrow-band imaging In this study,1382 patients with gastric polyps were retrospectively analyzed to study the clinical characteristics of gastric polyps,observe the fine structure characteristics of gastric polyps under ME-NBI,and explore the diagnostic value of ME-NBI in predicting the pathological types of gastric polyps.Materials and methodsCollected from January 2016 to January 2020 in the second affiliated hospital of zhengzhou university gastroscope examination revealed gastric polyps and confirmed by pathology of gastric polyps of the clinical data of 1382 patients(183 patients underwent high-definition magnification endoscopy combined with narrowband imaging observation,and 147 patients had complete data),to explore the clinical features of 1382 cases of gastric polyps and high-definition magnifying endoscopic characteristics of 147 cases of gastric polyps and according to different high definition magnifying endoscope combined narrow-band imaging characteristics of anticipation pathological type of gastric polyps,specific degree of sensitivity and accuracy and consistency;Analyzed by SPSS 23.0 software,measurement data using t test,counting data usingχ~2 test or Fisher’s exact test,Kappa consistency test was performed for consistency comparison,when P<0.05 was statistically significant.ResultsGastric polyps were more common in females,and the ratio of male to female was 1:2.23.Gastric polyps usually occur between the ages of 40 and 60.The common pathological types of gastric polyps are gastric fundus polyp,hyperplastic polyp,inflammatory polyp and adenomatous polyp in turn.Gastric polyps are more common and have a normal diameter<5 mm.The fundus and body of the stomach are the most common parts of polyps.Gastric polyps are often accompanied by atrophy of the gastric background mucosa.2.In ME-NBI,the sensitivity,specificity and accuracy of predicting gastric fundic gland polyps with small round were 94.32%,94.92%and 94.56%,respectively.The sensitivity,specificity and accuracy of predicting hypertrophic polyps or inflammatory polyps by prolonged were 86.54%,94.74%and 91.84%,respectively.The sensitivity,specificity and accuracy were 85.71%,97.14%and 96.60%respectively for the prediction of adenomatous polyps by villous or ridges.According to the above ME-NBI,the Kappa value of the consistency test of micromucosal morphological diagnosis and pathological diagnosis was 0.845(P<0.05).3.In ME-NBI,the sensitivity,specificity and accuracy of predicting fundic gland polyp using honeycomb were 94.32%,94.92%and 94.56%,respectively.The sensitivity,specificity and accuracy of predicting hypertrophic gastric polyps and inflammatory polyps with dense vascular were 94.23%,94.74%and 94.56%,respectively.The sensitivity,specificity and accuracy of predicting adenomatous polyps using core vascular were 85.71%,100.00%and 99.32%,respectively.According to the above ME-NBI,the Kappa value of the consistency test of micromucosal morphological diagnosis and pathological diagnosis was 0.895(P<0.05).4.In ME-NBI,the sensitivity,specificity and accuracy of predicting fundic gland polyps using small round and honeycomb were 94.32%,94.92%and 94.56%,respectively.The sensitivity,specificity and accuracy of predicting hyperplastic polyps or inflammatory polyps using prolonged and dense vascular were 86.54%,94.74%and 91.84%,respectively.The sensitivity,specificity and accuracy of predicting hyperplastic polyps or inflammatory polyps using villous polyps or ridges and dense vascular were 7.70%,100.00%and 67.35%,respectively.The sensitivity,specificity and accuracy of predicting adenomatous polyps using villous or ridge and core vascula were 85.71%,100.00%and 99.32%respectively for villous or ridge and core vascular.The sensitivity,specificity and accuracy of predicting adenomatous polyps using unclear for were 14.29%,100%and 95.92%,respectively.According to the above ME-NBI,the Kappa value of the consistency test of micromucosa and microvascular morphological diagnosis and pathological diagnosis was 0.895(P<0.05).Conclusions1.Gastric polyps are most common in women over 40 years of age.Gastric fundus polyps are the most common pathologic type,usually single,with a diameter<5mm,mostly distributed in the fundus and the body of the stomach,the background mucosa is often accompanied by atrophy.2.The diagnosis of gastric polyps by ME-NBI has a high coincidence rate with pathological diagnosis,which can effectively predict the nature of gastric polyps and provide a reference for the treatment of gastric polyps.ME-NBI has good diagnostic value for pathological types of gastric polyps. |
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