Application Of Magnifying Endoscopy Of Early Gastric Cancer And Precancerous Lesions

BackgroundGastric cancer originated in the gastric epithelium of malignant,is one of the most common malignant tumors,according to the 2006 national tumor registration area statistics.The incidence of gastric cancer and mortality rates were 35.02 / 10 million and 26.08 / 10 million,respectively Located in the top three of all tumors,which is to harmful to the human's health.A large number of studies have shown that early gastric cancer and precancerous lesions endoscopic diagnosis and treatment are the important strategic measures,and should cause our attention.ObjectiveStudy the features of magnifying endoscopy combined indigo carmine,magnifying endoscopy combined acetic acid and magnifying endoscopy combined narrow-band imaging in the diagnosis of precancerous lesions and early gastric cancer screening.MethodsA prospective observational study was performed on patients who were conducted in the people's Hospital of Zhengzhou University from December 2014 to March 2016.81 patients found suspicious lesions in endoscopic or previous examination and come forward to join the study were chosen,and all the cases were stochasticly assigned to ME-IDC,ME-AA and ME-NBI groups.Surgical examination of the three groups of inflammation,intestinal metaplasia,low-grade intraepithelial neoplasia,early gastric cancer and positive lesions rate of detection of the incidence rate,is to evaluate its clinical Value.Results1.A total of 81 patients were enrolled,including 18 cases(22.22%)located in the upper 1/3 of stomach,15 cases(18.51%)located in the middle 1/3 of stomach,48 cases(59.26%)in the lower 1/3 of stomach.2.The detection rate of inflammatory lesions were 6 cases(21.43%)in ME-IDC group,10 cases(33.33%)in ME-AA group and 10 cases(43.48%)in ME-NBI group,the difference was not statistically significant(?~2=2.850,P=0.240>0.05).The detection rate of intestinal metaplasia were 11 cases(39.29%)in ME-IDC group,6 cases(20.00%)in ME-AA group and 8 cases(34.78%)in ME-NBI group,the difference was not statistically significant(?~2=2.124,P=0.346>0.05).The detection rate of low-grade intraepithelial neoplasia were 5 cases(17.86%)in ME-IDC group,6 cases(20.00%)in ME-AA group and1 cases(4.34%)in ME-NBI group,the difference was not statistically significant(?~2=3.029,P=0.220>0.05).The detection rate of early gastric cancer were 6 cases(21.43%)in ME-IDC group,8 cases(26.67%)in ME-AA group and 4 cases(17.39%)in ME-NBI group,the difference was not statistically significant(?~2=0.664,P=0.718>0.05).This study will bring low-grade intraepithelial neoplasia and early gastric cancer into positive lesions.The detection rate of positive lesions were 11 cases(39.29%)in ME-IDC group,14 cases(46.67%)in ME-AA group and 5 cases(21.74%)in ME-NBI group,the difference was not statistically significant(?~2= 3.562,P= 0.168>0.05).3.The results of endoscopic diagnosis of ME-IDC,ME-AA and ME-NBI were analyzed by using the pathological results of biopsy tissue as the gold standard for the diagnosis of early gastric cancer.The sensitivity of ME-IDC,ME-AA and ME-NBI in endoscopic diagnosis of early gastric cancer was 50.00%,77.78% and 100%,respectively.There was no significant difference(?~2 = 3.242,P = 0.286> 0.05).The specificity of ME-IDC,ME-AA and ME-NBI in endoscopic diagnosis of early gastric cancer was 59.09%,85.71% and 89.47% respectively,the difference was not statistically significant(?~2 = 6.633,P = 0.054> 0.05).The accuracy of ME-IDC,ME-AA and ME-NBI in endoscopic diagnosis of early gastric cancer was 57.14%,83.33% and 91.30%,respectively.The difference was statistically significant(?~2 = 9.473,P = 0.009 <0.05).The accuracy of ME-AA and ME-NBI in the diagnosis of early gastric cancer was higher than that of ME-IDC,the difference was statistically significant(?~2 = 4.795,P = 0.029 <0.05,?~2 = 7.399),P = 0.007 & lt;0.05).The accuracy of ME-AA and ME-NBI in the diagnosis of early gastric cancer was similar(83.33% vs 91.30%),the difference was not statistically significant(?~2 = 0.722,P = 0.685> 0.05).Conclusions 1.The lower 1/3 of gastric mucosal lesions in the proportion of the site is higher,endoscopic physician should focus on observation to prevent missing in the endoscopic operation;2.ME-NBI,ME-IDC and ME-AA are effective methods for detecting early cancer and precancerous lesions because of their effects on inflammation,inflammation,intestinal metaplasia,low grade intraepithelial neoplasia,early gastric cancer,The difference between the detection rate of lesions was not statistically significant,outpatient endoscopy screening can be based on the actual situation of endoscopic center selection of inspection methods;3.The results of endoscopic diagnosis of ME-IDC,ME-AA and ME-NBI were analyzed by using the pathological results of biopsy tissue as the gold standard for the diagnosis of early gastric cancer.The sensitivity and specificity between the three groups were analyzed,the difference was not statistically significant.ME-NBI and ME-AA were not significantly different between the two groups,but were significantly higher than those of ME-IDC.ME-NBI and ME-AA can significantly improve the accuracy of endoscopic diagnosis of early gastric cancer and guide the biopsy.They are simple and effective methods for the diagnosis of early gastric cancer.