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目的探讨NBI放大内镜在胃黏膜糜烂鉴别诊断中的价值,以及在胃黏膜癌前病变中的诊断价值。方法应用NBI电子放大内镜,对310例患者的胃黏膜糜烂灶进行细微结构形态学观察,并与观察部位活检所得的病理组织学改变进行比较分析。结果胃黏膜糜烂灶处胃小凹形态未见到A型、B型者;365处C型中组织病理均为慢性活动性浅表性炎症;160处D型中,92.5%(148/160)为萎缩性炎症;65处E型中,86.15%(56/65)为肠上皮化生;35处F型中,91.42%(32/35)为异型增生,8.57%(3/30)为肠上皮化生。59例肠上皮化生未发现明显异常增生的毛细血管,而32例异型增生的F型黏膜表面。90.63%(29/32)呈现出不同程度异常增生的毛细血管。与病理组织学比较,NBI放大内镜观察胃黏膜糜烂小凹形态与病理组织学改变呈显著正相关(P<0.01)。结论 NBI放大内镜在胃黏膜糜烂灶性质的判断中有很高的临床应用价值,可应用于胃黏膜癌前病变的普查。
Objective To investigate the value of NBI magnifying endoscopy in the differential diagnosis of gastric mucosal erosion and its value in the diagnosis of precancerous lesions of gastric mucosa. Methods NBI electronic magnifying endoscopy was used to observe the microscopic morphology of gastric mucosal lesions in 310 patients and to analyze the histopathological changes of biopsy specimens. Results There was no type A or type B in the gastric pits at gastric mucosal lesions. The histopathological features of type C at 365 sites were all chronic active superficial inflammation. Among 160 type D, 92.5% (148/160) Of them were atrophic inflammation; 86.15% (56/65) of 65 E were intestinal metaplasia; among 35 F, 91.42% (32/35) were dysplasia, and 8.57% (3/30) Epithelial metaplasia. 59 cases of intestinal metaplasia did not find significant abnormal proliferation of capillaries, and 32 cases of dysplasia of the F-type mucosal surface. 90.63% (29/32) showed different degrees of abnormal proliferation of capillaries. Compared with histopathology, there was a significant positive correlation between NBI magnifying endoscopic observation of gastric mucosal erosions and pathological changes (P <0.01). Conclusion NBI magnifying endoscopy in the determination of the nature of gastric mucosal erosion has a high clinical value, can be applied to gastric precancerous lesions in the census.