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王一岚, 严海琳, 吴俊超等. EUS及ME-NBI对早期食管癌浸润深度诊断准确性的临床分析[J]. koko体育app 学报（医学版）, 2018, 49(6): 840-844.
引用本文: 王一岚, 严海琳, 吴俊超等. EUS及ME-NBI对初期食管癌侵润进一步判断较准性的临床治疗具体分析[J]. 云南学校学报（医学检验版）, 2018, 49(6): 840-844.
WANG Yi-lan, YAN Hai-lin, WU Jun-chao. et al. Accuracy of EUS and ME-NBI for Evaluating the Invasion Depth of Early Esophageal Cancer[J]. Journal of Sichuan University (Medical Sciences), 2018, 49(6): 840-844.
Citation: WANG Yi-lan, YAN Hai-lin, WU Jun-chao. et al. Accuracy of EUS and ME-NBI for Evaluating the Invasion Depth of Early Esophageal Cancer[J]. Journal of Sichuan University (Medical Sciences), 2018, 49(6): 840-844.

EUS及ME-NBI对早期食管癌浸润深度诊断准确性的临床分析

Accuracy of EUS and ME-NBI for Evaluating the Invasion Depth of Early Esophageal Cancer

  • 摘要: 目的 探讨超声内镜（EUS）及放大内镜-窄带成像技术（ME-NBI）对早期食管癌浸润深度的诊断准确性。 方法 回顾性纳入2013年3月至2017年10月术前诊断为早期食管癌并行内镜下治疗的患者，比较术前EUS和ME-NBI对病变浸润深度的判断与术后病理浸润深度的一致率。结果 本研究共纳入333例患者（392处病灶），其中轻中度不典型增生83处，重度不典型增生72处，鳞状细胞癌235处，腺鳞癌2处。308处病灶仅经过EUS检查，7处病灶仅经过ME-NBI检查，77处病灶同时经过两种方式检查。385处病灶经EUS评估，对病变浸润深度的诊断准确率为43.9%（169/385），与病理诊断一致性差（Kappa=0.1）。对局限于黏膜层的病变EUS准确率为40.8%（139/341），黏膜下层病变准确率为68.2%（30/44）（P=0.001）。84处病灶经ME-NBI评估，对病变浸润深度的诊断准确率为72.6%（61/84），与病理诊断具有中等一致性（Kappa=0.4），对局限于黏膜层的病变其准确率为91.0%（71/78），对于达黏膜下层的病变其准确率为16.7%（1/6）。同时行EUS及ME-NBI检查的77处病灶，EUS诊断准确率为42.9%（33/77），ME-NBI对浸润深度的诊断准确率为84.3%（67/77）（P=0.001）。结论 ME-NBI对早期食管癌浸润深度的评估优于EUS。  
    Abstract: Objective To assess the accuracy of endoscopic ultrasound (EUS) and magnifying endoscopy with narrow-band imaging (ME-NBI) in evaluating the invasion depth of early esophageal carcinoma. Methods Patients who underwent endoscopic resection for early esophageal cancer from March 2013 to October 2017 were enrolled. The EUS and ME-NBI results were compared with the pathology results. Results A total of 392 lesions from 333 patients were assessed, including 83 mild and moderate dysplasia, 72 severe dysplasia, 235 squamous cell carcinoma, and 2 adenosquamous carcinoma. About 308 lesions were given EUS only, 7 had ME-NBI only, 77 underwent both EUS and ME-NBI. EUS resulted in a 43.9% accuracy for the 385 lesions, with poor consistency (Kappa=0.1) with the pathology results. But higher accuracy (68.2%) was found for lesions infiltrating into the submucosa of the lesions, compared with 40.5% for lesions contained within the mucosa (P=0.001). ME-NBI resulted in a 72.6% accuracy for the 84 lesions, with a medium consistency (Kappa=0.4). The accuracy for lesions contained within the mucosa was 91.0%, compared with 16.7% for lesions infilrtrating into the submucosa (P=0.001). EUS and ME-NBI for the 77 lesions demonstrated an accuracy of 42.9% for the EUS and 84.3% for the ME-NBI (P=0.001). Conclusion ME-NBI has higher accuracy than EUS in evaluating the invasion depth of early esophageal carcinoma.  
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