The Comparative Study Of Narrow Band Imaging Technique And Chromoendoscopy In The Diagnosis Of Early Gastric Cancer

ObjectiveUsing narrow band imaging technique and chromoendoscopy to value the suspicious lesions which were detected by conventional endoscopy,and then compare the diagnostic accuracy of Narrow Band Imaging(NBI) in early gastric cancer with the diagnostic accuracy of chromoendoscopy.MethodsWe just choose patients from those who have taken endoscopic examination in Shan Dong Provincial Hospital from June to October in 2008.Patients,who have been detected suspicious lesions by conventional endoscopy,were then observed by Narrow Band Imaging(NBI) and chromoendoscopy separately.We valued these lesions according to the microstructure of mucosa.Biopsies were then taken under endoscopy. We follow up those patients who took surgical operations or endoscopy therapies for their histological results.Among all patients,46 patients were enrolled in our study, aging 25 to 80years,and the average age is 56.52.Among these patients,there are 29 men,and 17 women.In the end,comparisons were make between NBI and chromoendoscopy by reference to histopathology to determine which technique has the higher diagnostic accuracy.ResultAmong all patients,those who have taken endoscopic examination in Shandong Provincial Hospital from June to October in 2008,46 patients were enrolled in our study.According to the final pathology results,13 lesions have been finally confirmed as ECG among these 46 patients.Among these lesions 4 lesions are restricted to mucosa layer,while 9 are submucosal cancer.Among these leisions,10 leisions are referred to typeⅡc,1 is referred to typeⅡa,while 2 are referred to typeⅡa+Ⅱc.5 are moderately differented adnocarcinoma,while 9 are poorly differented adnocarcinoma.NBI system has innitially diagnosed 15 suspicious lesions as ECG, while 14 lesions have been initially diagnosed by chromoendoscopy.As referred to the result of histopathology,13 suspicious lesions are demonstrated as ECG finally.The diagnostic accuracy,sensitivity and specificity of NBI and chromoendoscopy are 91.3%,96.8%,80.0%and 84.7%,90.6%,71.4%separately,while the positive rate, false positive rate,negative rate and false negative rate of NBI and chromoendoscopy are92.31%,90.91%,9.09%,7.69%and 76.92%,87.88%,12.12%,23.08%separately, with 0.5＜P＜0.75.ConclusionObservation of gastric mucosal pit pattern by NBI system is no better than by chromoendoscopy with P＞0.05,while observation of gastric mucosal microvascular structure by NBI system is better than by chromoendoscopy with P＜0.05.The diagnostic accuracy,sensitivity and specificity of NBI and chromoendoscopy are 91.3%,96.8%,80.0%and 84.7%,90.6%,71.4%separately,while the positive rate, false positive rate,negative rate and false negative rate of NBI and chromoendoscopy are92.31%,90.91%,9.09%,7.69%and 76.92%,87.88%,12.12%,23.08%separately. accuracy of chromoendoscopy with 0.5＜P＜0.75.That is to say,NBI system can not replace chromoendoscopy,but as a complementary technique it will have a wider prospect of application in the future.