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目的探讨富士能智能分光染色内镜(FICE)放大内镜联合乙酸染色对胃黏膜肠上皮化生(GIM)的诊断价值。方法疑似GIM患者480例随机分为普通内镜组、乙酸染色组、美蓝染色组、FICE放大内镜联合乙酸染色组各120例,以病理诊断为金标准,比较不同方法诊断肠上皮化生的差异。结果普通内镜组与乙酸染色组诊断GIM的灵敏度、特异度、准确率差异无统计学意义(P>0.05),美蓝染色组与乙酸染色组的灵敏度、准确率差异有统计学意义(P<0.05)。FICE放大内镜联合乙酸染色组与美蓝染色组的特异度、准确率差异有统计学意义(P<0.05);FICE放大内镜联合乙酸染色组的阳性似然比、优势比、Kappa值均明显高于美蓝染色组,阴性似然比则明显低于后者(P<0.05)。结论 FICE放大内镜联合乙酸染色可提高GIM定向活检准确率,显著降低漏诊率及误诊率,且与病理诊断的一致性较好,具有更高的临床诊断应用价值。
Objective To investigate the diagnostic value of Fuji Nerve Spectroscopy (FICE) magnifying endoscopy combined with acetic acid staining for gastric mucosa intestinal metaplasia (GIM). Methods 480 patients with suspected GIM were randomly divided into general endoscopy group, acetic acid staining group, methylene blue staining group, FICE magnifying endoscopy combined with acetic acid staining group of 120 cases, pathological diagnosis as the gold standard, compared with different methods to diagnose intestinal metaplasia The difference. Results There was no significant difference in the sensitivity, specificity and accuracy of GIM between ordinary endoscopic group and acetic acid staining group (P> 0.05), and there was significant difference between sensitivity and accuracy of methylene blue staining group and acetic acid staining group (P <0.05). The specificity and accuracy of FICE magnification endoscopy combined with acetic acid staining and methylene blue staining were significantly different (P <0.05). The positive likelihood ratio, Kappa value Was significantly higher than methylene blue staining group, the negative likelihood ratio was significantly lower than the latter (P <0.05). Conclusion FICE magnifying endoscopy combined with acetic acid staining can improve the accuracy of GIM directional biopsy, significantly reduce the misdiagnosis rate and misdiagnosis rate, and the consistency with the pathological diagnosis is better, and has a higher clinical diagnostic value.