The Value Of Acetic Acid Staining Combined With Blue Laser Imaging In The Diagnosis Of Low-grade Intraepithelial Neoplasia Of Gastric Mucosa

Objective: To investigate the diagnostic value of glacial acetic acid staining combined with blue laser imaging(AA-BLI)in low grade intraepithelial neoplasia(LGIN)of gastric mucosa.Methods: To analyze 200 cases of suspected LGIN patients in digestive endoscopy center of Jilin Provincial People’s Hospital from 2018 to 2019.All the patients were randomly divided into 4 groups.They were examined by white light endoscopy(WLI group),glacial acetic acid staining(AA group),blue laser endoscopy(BLI group),glacial acetic acid staining combined with blue laser endoscopy(AA-BLI).The pictures were saved and the pathology was obtained.During the examination,one assistant recorded the whitening time.After the examination,three senior endoscopists(Expert Group)and three junior endoscopists(non expert group)observed the pictures respectively to make endoscopic diagnosis and image quality assessment.The pathological results were diagnosed by three pathologists at the same time.The data were collected in detail for statistical analysis,and the diagnostic value of AA-BLI in LGIN gastric mucosa was evaluated.Results: The sensitivity,specificity and accuracy of AA-BLI in the diagnosis of LGIN were higher than those of WLI group,AA group and BLI group.Compared with WLI group,the sensitivity,specificity and accuracy of AA group and BLI group were all increased,but the increase was not significant.There was no significant difference in sensitivity,specificity and accuracy between BLI group and AA group.The results show that AA endoscopy and BLI endoscopy alone can improve the accuracy of LGIN diagnosis,but the effect is not obvious.The combination of AA-BLI can significantly improve the accuracy of LGIN diagnosis,which has important clinical significance.After spraying AA,we can judge the nature of the lesions by the time of mucosal albinism.The shorter the time of mucosal albinism,the higher the malignant degree of the lesions.The difference is statistically significant.There was no significant difference in image quality between the expert group and the non expert group of AA-BLI group.It is suggested that AA-BLI can improve the observation effect of lesions under the microscope regardless of the age of endoscopist.Conclusion: Regardless of the seniority of endoscopists,AA-BLI group was beneficial to observe the surface microstructure and lesion boundary of LGIN,significantly improve the accuracy of targeted biopsy,reduce the missed diagnosis rate and the underestimation rate of pathology.