The Clinical Value Of Narrow-band Imaging Combined With Magnifying Endoscopy In Diagnosis Of Early Esophageal Cancer And Precancerous Lesions

Objective:To study the clinical value of Narrow-band imaging combined with magnifying endoscopy in diagnosis of early esophageal cancer and precancerous lesions.Methods:With pathological grading respectively using ordinary white light endoscopy, NBI, staining endoscopy in esophageal mucosa abnormality were observed to evaluate three methods for early esophageal cancer and precancerous lesion detection rate of three kinds of method definition of analysis; the NBI with magnifying endoscopy squamous papillary capillary loop(IPCL) changes and grading in suspected lesions is the most obvious place for biopsy and the histopathological examination; diagnosis of early esophageal cancer and precancerous lesions with endoscopic mucosal resection / endoscopic submucosal resection, preoperative and postoperative pathological examination results were compared; comparing NBI, iodine staining was graded.Results:(1) the coincidence rate of common white endoscopy, NBI and endoscopy was 53.44%, 83.21%, 87.02%. Data show that the coincidence rate of NBI and iodine staining and pathology was significantly higher than that of ordinary white endoscopy.(2) NBI has obvious advantages in the diagnosis of esophageal carcinoma and precancerous disease.(3) NBI and stained endoscopy were no difference in the definition of the lesion boundary(P=0.465). The NBI pattern of the A8 was observed in the mucosa gland, and the B8 pattern was superior to the endoscopy.(4) the high-grade intraepithelial neoplasia and early cancer mainly showed that there are 56 I NBI, II NBI, III grade 11, and 30 negative.. The main features of low-grade intraepithelial neoplasia are I NBI grade 8, II NBI, III grade 31, and 8 negative.. Analysis of statistical results.P=0.000,Spearman=0.656. P=0.000,Kappa=0.535. HGIN and early cancer showed that there are 60 NBI I, II III, NBI grade 7, and 4 negative.The main features of LGIN are 7 I NBI, II NBI, III grade 35, and 5 negative. Correlation analysis of statistical results Spearman=0.733,P=0.000;Kappa=0.689,P=0.000. Data show that: NBI grading, iodine staining grading in the whole course of the esophagus and pathology has a correlation.(5) esophagitis patients IPCL type to type I and type II, type I-II(84.62%; IPCL in patients with LGIN type II and III, II, III type 63.83%; microvessels in patients with high-grade type to type IV, type IV accounted for 71.19%; early esophageal cancer patients to V1, V2, V3, V1, V2, V3(100%). The data show that the morphology of IPCL is consistent with the pathology.Conclusions:Narrow band imaging(NBI) is a kind of optical image enhancement technology which can enhance the surface morphology of the mucosa and the surface of the mucosa by special spectral changes.The morphology of IPCL can be observed by magnifying endoscopy, and it can reflect the histological features of atypical hyperplasia and small lesions and can guide the biopsy of the lesions under endoscopy. Therefore, NBI combined with magnifying endoscopy in the diagnosis of early and precancerous lesions has clinical value, which is worthy of further study.