设为首页 | 加入收藏
| 欢迎光临本站!

消化内镜学分会官方网站

当前位置:文献追踪 > 国内外期刊

内窥镜杂志 2014; 46(10): 827-832

发布日期:2014-11-4 10:59:29 文章来源: 作者次数:1370

    内窥镜杂志 2014; 46(10): 827-832

    DOI: 10.1055/s-0034-1377524

    研究论文

    © Georg Thieme Verlag KG Stuttgart · 纽约

    显微内镜下细胞异型性诊断胃癌的精准度和一致性分析

    Mitsuru Kaise1, Ryusuke Kimura1, Kosuke Nomura1, Yasutaka Kuribayashi1, Daisuke Kikuchi1, Toshiro Iizuka1, Yasuo Ohkura2

    1胃肠病科, Toranomon 医院, 东京, 日本

    2病理科, Kyorin 大学医疗中心, 东京, 日本

     

    研究背景和目的:

    显微内镜下的高度异型性是诊断胃癌的一个重要标准,我们计划通过研究内镜使用新手和专家通过显微内镜的高度异型性,是否能提供精准性和一致性令人满意的诊断检查结果。

    方法:

    总共100例显微内镜和组织病理学检查的切片合集纳入研究范围(包括44 例早癌, 10例低分化腺瘤,46 例非肿瘤).4名内镜师 (包括两名新手,两名专家) 分别阅览了切片合集,评估他们各自显微内镜下异型性的存在或不存在的诊断。显微内镜下的高度异型性,是作为诊断癌症的一个标准。异型性包括持续观察到以下三个典型特性的任何一个:管腔缺失,管腔融合和不规则的细胞核(核形状各异,膨大,形状混乱)。

    结果:

    高度异型性在癌症,腺瘤,非肿瘤用显微内镜分别观察到了78 %, 18 %, 和 4 %。对癌症诊断的敏感性,特异性,精准性,阳性与阴性预测率分别为78.4 %, 93.3 %, 87.3 %, 85.4 %和87.3 %。4名内镜学者对高度异型性的分析一致性较好(k值0.682)。显微内镜学者里的新手和专家之间在诊断精准性和一致性上没有显著差异。

    结论:

    高度异型性作为诊断癌症的一个标准已经明确,而不论内镜操作者的经验是否丰富,显微内镜都提供了令人满意的早期胃癌诊断的精确性和一致性。



    Endoscopy 2014; 46(10): 827-832

    DOI: 10.1055/s-0034-1377524

    Original article

     

    © Georg Thieme Verlag KG Stuttgart · New York

    Accuracy and concordance of endocytoscopic atypia for the diagnosis of gastric cancer

     

    Mitsuru Kaise1, Ryusuke Kimura1, Kosuke Nomura1, Yasutaka Kuribayashi1, Daisuke Kikuchi1, Toshiro Iizuka1, Yasuo Ohkura2

    1Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan

    2Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan

     

    Background and aim: High-grade atypia demonstrated by endocytoscopy may be a key criterion for the diagnosis of gastric cancer. We therefore sought to verify whether endocytoscopic atypia can provide satisfactory levels of diagnostic accuracy and concordance among trainee and expert endoscopists.

     

    Method: A total of 100 lesions evaluated by endocytoscopy and histopathology were enrolled to create an endocytoscopic image catalog (44 early cancers, 10 low-grade adenomas, 46 non-neoplastic lesions). Four endoscopists (two trainees and two experts) independently reviewed the catalog images and evaluated each of them for the presence or absence of endocytoscopic atypia. High-grade endocytoscopic atypia, as a criterion for cancer diagnosis, was defined as the consistent observation of any of the following features: lumen absence, lumen fusion, and irregular nuclei showing the three typical features (heterogeneous shape, swelling, and disarrangement).

     

    Results: High-grade endocytoscopic atypia was observed in 78 %, 18 %, and 4 % of cancers, adenomas, and non-neoplastic lesions, respectively. The sensitivity, specificity, accuracy, and positive and negative predictive values for cancer diagnosis by endocytoscopy were 78.4 %, 93.3 %, 87.3 %, 85.4 %, and 87.3 %, respectively. The concordance rate for the results of high-grade endocytoscopic atypia was good among the four endoscopists (κ value 0.682). No significant difference in diagnostic accuracy or concordance was observed between trainee and expert endoscopists.

     

    Conclusion: Using the defined high-grade atypia as a diagnostic criterion of cancer, endocytoscopy provided a satisfactory level of accuracy and concordance for the diagnosis of early gastric cancer, regardless of endoscopic expertise.


    (作者:)
相关评论
用户名: 登录