Application of narrow-band imaging and iodine staining in early esophageal cancer screening
窄带成像与碘染色在早期食管癌筛查中的应用

摘要

目的 分析窄带成像与碘染色在早期食管癌筛查中的应用价值。方法 回顾性分析2020年08月-2021年12月间我院门诊及住院接受常规胃镜检查患者1089例临床资料，所有患者均于病理检查前接受窄带成像技术（NBI）与碘染色检查，并按照筛查方法分为对照组（行窄带成像技术检查）、实验组（窄带成像技术联合碘染色检查），以病理检查为金标准，比较两种筛查方式的诊断价值。结果 1089例常规胃镜检查患者中，对照组单纯NBI的活检例数为142例（13.04%），其中颈段3例、胸上段病变37例，胸中段病变67例，胸下段病变35例；实验组窄带成像技术联合碘染色的活检数为180例（16.53%），其中颈段3例、胸上段病变42例，胸中段病变83例，胸下段病变52例。对照组中检出早期食管癌病例数12例，发现低级别病灶数16例、高级别病灶部位10例、原位癌2例，观察组中检出早期食管癌病例数与对照组相同，但发现低级别病灶数（20个部位）、高级别病灶部位（14个部位）、原位癌（2个部位）。两组检出例数对比无统计学意义（P＞0.05），但在联合碘染色检查后虽然早期食管癌的病例数无增加，但是同一病人发现多病灶部位。结论 窄带成像与碘染色分别在早期食管癌筛查中均具有较为理想的筛查和诊断价值，但将两者联合进行筛查与诊断可实现诊断效果的进一步提高。

Abstract

Objective: To analyze the application value of narrow-band imaging and iodine staining in early esophageal cancer screening.
Methods: The clinical data of 1089 outpatients and inpatients who underwent routine gastroscopy in our hospital from August 2020 to December 2021 were retrospectively analyzed. All patients underwent narrow-band imaging (NBI) and iodine staining before pathological examination. According to the screening method, the patients were divided into control group (narrowband imaging technique) and experimental group (narrowband imaging technique combined with iodine staining). The diagnostic value of the two screening methods was compared with pathological examination as the gold standard.
Results: Among 1089 patients undergoing routine gastroscopy, 142 (13.04%) cases of pure NBI biopsy in the control group, including 3 cases of cervical segment, 37 cases of upper thoracic segment, 67 cases of middle thoracic segment, and 35 cases of lower thoracic segment. In the experimental group, the number of biopsies by narrow-band imaging combined with iodine staining was 180 (16.53%), including 3 cases of cervical lesions, 42 cases of upper thoracic lesions, 83 cases of middle thoracic lesions, and 52 cases of lower thoracic lesions. Detection, 12 cases of early esophageal cancer cases in control group, found that the low level of lesion number 16 cases, 10 cases of high level lesion, 2 cases were carcinoma in situ, detection of early esophageal cancer cases in the observation group and control group in the same, but found that low level number of lesions (20), high level of lesion (14), carcinoma in situ (2 parts). There was no significant difference in the number of cases detected between the two groups (P > 0.05), but although the number of early esophageal cancer cases did not increase after combined iodine staining, multiple lesions were found in the same patient.
Conclusion  : Both narrow-band imaging and iodine staining have ideal screening and diagnostic value in early esophageal cancer screening, but the combination of them can further improve the diagnostic effect.