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西南医科大学附属成都三六三医院消化内科 四川 成都 610000
Received:22 March 2024,
Published:25 June 2025
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刘茂,陈天明,宋欢等.胃小凹Sakaki分型联合靛胭脂染色对胃部病变的诊断价值[J].武汉大学学报(医学版),2025,46(06):787-792.
LIU Mao,CHEN Tianming,SONG Huan,et al.Diagnostic value of Sakaki classification combined with indigo carmine staining in gastric lesions[J].Medical Journal of Wuhan University,2025,46(06):787-792.
刘茂,陈天明,宋欢等.胃小凹Sakaki分型联合靛胭脂染色对胃部病变的诊断价值[J].武汉大学学报(医学版),2025,46(06):787-792. DOI: 10.14188/j.1671-8852.2024.0196.
LIU Mao,CHEN Tianming,SONG Huan,et al.Diagnostic value of Sakaki classification combined with indigo carmine staining in gastric lesions[J].Medical Journal of Wuhan University,2025,46(06):787-792. DOI: 10.14188/j.1671-8852.2024.0196.
目的
2
探讨内镜下窄带成像(NBI)胃小凹Sakaki分型联合靛胭脂染色对胃部病变诊断的价值。
方法
2
选择2019年10月至2023年10月于西南医科大学附属成都三六三医院就诊发现的97例胃内疾病患者为研究对象,其中对照组采用NBI进行检查,观察组采用NBI联合靛胭脂染色进行检查。比较两组患者检查结果,比较两组检查结果和病理检查结果的一致性,分析两组对胃部病变的诊断价值。采用广义估计模型分析两组诊断胃部病变的置信度。
结果
2
本研究中97例患者共发现141处局灶性病变,其中慢性胃炎72处(51.06%),肠上皮化生32处(22.70%),低级别上皮内瘤变5处(3.55%),高级别上皮内瘤变和胃癌32处(22.70%)。观察组检查结果与病理诊断结果的一致性(
Kappa
=0.76)大于对照组(
Kappa
=0.34)。观察组诊断胃部病变的准确率为95.74%、灵敏度87.50%、特异度98.17%、阳性预测值93.33%、阴性预测值96.40%均高于对照组的83.69%、56.25%、91.74%、66.67%、87.72%,差异均有统计学意义(
P
<
0.05)。观察组诊断慢性胃炎、肠上皮化生、低级别上皮内瘤变及高级别上皮内瘤变和胃癌的置信度明显优于对照组(
P
<
0.05)。
结论
2
窄带成像内镜下胃小凹Sakaki分型和靛胭脂染色对胃部病变的检查具有较高的检出率和准确率,值得临床推广应用。
Objective
2
To explore the value of narrowband imaging(NBI) endoscopic gastric foveola Sakaki typing combined with indigo carmine staining in diagnosing gastric lesions.
Methods
2
From October 2019 to October 2023
ninety⁃seven gastric disease patients at Chengdu 363 Hospital
affiliated with Southwest Medical University
were selected as the study subjects. The control group was examined using NBI
while the observation group was examined using NBI combined with indigo carmine staining. The results of the two groups were compared
and the consistency of results with pathological findings was analyzed to evaluate the diagnostic value for gastric lesions. A generalized estimating equation model was used to analyze the confidence level of diagnosing gastric lesions in both groups.
Results
2
A total of 141 focal lesions were found in 97 patients
including 72 cases of chronic gastritis (51.06%)
32 cases of intestinal metaplasia (22.70%)
5 cases of low‑grade intraepithelial neoplasia (3.55%)
and 32 cases of high‑grade intraepithelial neoplasia and gastric cancer (22.70%). The consistency between the examination results of the observation group and pathological diagnosis (
Kappa
=0.76) was higher than that of the control group (
Kappa
=0.34). The accuracy rate
sensitivity
specificity
positive predictive value
and negative predictive value of the observation group for diagnosing gastric lesions were 95.74%
87.50%
98.17%
93.33%
and 96.40%
respectively
which were all higher than those of the control group (83.69%
56.25%
91.74%
66.67%
87.72%)
and the differences were statistically significant (
P
<
0.05). The confidence level of the observation group in diagnosing chronic gastritis
intestinal metaplasia
low‑grade intraepithelial neoplasia
high‑grade intraepithelial neoplasia
and gastric cancer was significantly higher than that of the control group (
P
<
0.05).
Conclusion
2
The Sakaki classification and indigo carmine staining under narrowband imaging endoscopy have a high detection rate and accuracy in the examination of gastric lesions
and are worthy of clinical promotion and application.
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