首页> 中文期刊> 《实用医学杂志》 >联动成像内镜与白光内镜对胃黏膜感染幽门螺杆菌的诊断价值比较

联动成像内镜与白光内镜对胃黏膜感染幽门螺杆菌的诊断价值比较

         

摘要

Objective To investigate the ability of linked color imaging(LCI)for diagnosing Helicobacter Pylori(Hp)infection compared with conventional white light imaging(WLI). Methods We prospectively collected subjects who underwent gastroscopy. Images under both WLI and LCI were recorded and analyzed. Software was used to measure pixel brightness for red(R),green(G),blue(B)of endoscopic images from suspected lesion sites. Biopsies were taken from these sites and Warthin-Starry silver staining was used to detect if Hp was present. R/(G+B)value was used to construct receiver operating characteristic curve(ROC)to predict Hp infec-tion and the area under curve(AUC),cut-off point,sensitivity,as well as specificity were calculated with the patho-logy as the gold standard. Results Forty-seven subjects(23 men,24 women;23 Uygur subjects,24 Han subjects) were included in a mean age of 49 years old. Ninety-one biopsies were obtained. Forty-four biopsies (48.4%)were Hp positive according to the pathology. The AUC of LCI was 0.616,with the cut-off point at 0.967 and sensitivity at 0.955 and specificity at 0.298. The AUC of WLI was 0.529,with cut-off point at 2.638 and sensi-tivity at 0.455 and specificity at 0.766. The AUC of Han and Uygur subjects were 0.650 and 0.549 by LCI. The AUC of atrophy gastritis subjects and non-atrophy gastritis subjects were 0.628 and 0.603. Conclusion LCI was superior to WLI in predicting Hp infection. LCI may act as an objective and quantified endoscopic diagnostic meth-od in Hp infection.%目的 比较联动成像内镜(LCI)与传统白光内镜对胃黏膜幽门螺杆菌(Hp)感染的诊断价值.方法 用白光和LCI模式分别观察胃黏膜,用取色软件测量两种模式下可疑Hp感染区域的红色(R)、绿色(G)、蓝色(B)的组成值,并对可疑部位取活检行病理检测,R/(G+B)比值用于建立预测Hp感染的受试者工作特征曲线(ROC),并计算曲线下面积(AUC)、cut-off值及灵敏度和特异度.结果 共纳入47例研究对象,其中维吾尔族23例,平均49岁.共获得91例病理组织,确诊Hp感染44例.LCI模式建立的曲线的AUC为0.616,cut-off值为0.967,灵敏度为0.955,特异度为0.298;白光模式建立的曲线的AUC为0.529,cut-off值为2.638,灵敏度为0.455,特异度为0.766.LCI诊断汉族和维吾尔族Hp感染的AUC分别为0.65、0.549.LCI诊断萎缩性胃炎和非萎缩性胃炎患者Hp感染的AUC分别为0.628、0.603.结论 LCI模式较白光模式诊断胃黏膜Hp感染具有更高的诊断效能,可作为一种客观的内镜下辅助判断胃黏膜Hp感染的定量方法.

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