The Value Of Endoscopic Acetic Acid Staining Combined With Blue Laser Imaging In The Diagnosis Of Early Gastric Cancer And Precancerous Lesions

Objective:To evaluate the clinical value of acetic acid staining combined with blue laser imaging by analyzing its detectable rate for precancerous lesions and early gastric cancer.Methods:Patients who were screened out abnormal mucosal morphology(unevenness,depression,and elevation)and mucosa showing abnormal color(mainly redness and whitening)through ordinary white light endoscopy at the Department of Digestive Endoscopy from the Second Affiliated Hospital of Hainan Medical University from May 2019 to November 2020 are selected,and a total of 105 patients are included according to the inclusion and exclusion criteria.The focal lesion is observed by using 2 kinds of endoscopy including ordinary white light endoscopy and acetic acid staining combined with blue laser.At the same time,the patient’ s name,age,gender,telephone and clinical symptoms are recorded.After completing the endoscopic examination,the endoscopic physician makes a preliminary diagnosis under the endoscopy.The disposable biopsy forceps are used to take multi-point mucosal tissue at the edge of the lesion for pathological biopsy.The pathological diagnosis is used as the gold standard to compare the detectable rates of white-light endoscopy,acetic acid staining combined with blue laser for precancerous lesions and early gastric cancer.Results:The specificity and sensitivity of ordinary white light endoscopy for the detection of cancerous lesions are 96.8% and 41.7%,respectively.The specificity and sensitivity of acetic acid combined with blue laser for the diagnosis of cancerous lesions are 98.9% and 91.7%,respectively.The consistency of white light endoscopy,acetic acid combined with blue laser and cancerous lesions of pathological diagnosis are 90.5%(95/105)and 98.1%(103/105),respectively.The consistency of the two methods for the diagnosis of cancerous lesions tested by X~2 shows that the difference is statistically significant(P <0.05),with Kappa values of 0.450 and0.906.The specificity and sensitivity of white light endoscopy in the diagnosis of low-grade intraepithelial neoplasia are 93.2% and 41.2%,respectively.The specificity and sensitivity of acetic acid staining combined with blue laser in the diagnosis of low-grade intraepithelial neoplasia are 97.7% and 82.4%,respectively.The consistency of white light endoscopy,acetic acid staining combined with blue laser and pathological diagnosis of low-grade intraepithelial neoplasia are 84.8%(89/105)and95.2%(100/105),respectively.The consistency of the two methods in the diagnosis of low-grade intraepithelial neoplasia tested by X~2 shows that the difference is statistically significant(P <0.05),with Kappa values is 0.380 and 0.820,respectively.Conclusions:Compared with white light endoscopy,the detectable rate of acetic acid staining combined with blue laser for precancerous lesions and early gastric cancer is significantly higher,and its specificity and sensitivity are also higher,and the consistency of acetic acid combined with blue laser in the diagnosis of cancerous lesions,low-grade intraepithelial neoplasia and pathological results is better,and the difference is statistically significant,which means that the method of acetic acid staining combined with blue laser can improve the detectable rate of gastric precancerous lesion and early gastric cancer.