背景:常规放大内窥镜与窄带成像(NBI)观察胃体粘膜显示与收集小静脉的规则排列有关的优势模式,上皮下毛细血管网络,还有胃坑.
目的:为了评估新的单双(近)焦点的有效性,NBI模式评估胃体粘膜的显微特征与常规放大相比。
方法:在2021年和2022年期间,68例患者使用放大内镜方式接受了近端胃肠内镜检查,随后应用乙酸(AA)。具有双聚焦能力的GIF-190HQ系列NBI系统用于胃粘膜的研究。在内窥镜检查的时候,采用白光内镜(WLE)对所有入选患者的胃体黏膜进行拍照,近焦点(NF)NF-NBI,AA-NF,和AA-NF-NBI模式。
结果:WLE,所有患者的NF和NF-NBI内镜模式(204张图像)按相同顺序分为三组。以相同的顺序对每位患者的AA-NF和AA-NF-NBI内窥镜模式的两张图像进行分类。据三位独立完成工作的观察员说,NF放大倍数明显优于WLE(P<0.01),NF-NBI模式明显优于NF放大倍数(P<0.01)。申请AA后,3位观察者证实AA-NF-NBI明显优于AA-NF(P<0.01)。WLE的观察者kappa值分别为0.609、0.704和0.598,分别为0.600、0.721和0.637,NF放大。对于NF-NBI模式,数值分别为0.378,0.471和0.553.对于AA-NF,分别为0.453、0.603和0.480,对于AA-NF-NBI,分别为0.643、0.506和0.354。
结论:在微观细节研究胃粘膜时,NF-NBI是评估收集小静脉规则排列的最强大的内镜模式,上皮下毛细血管网络,在这项研究中调查的五种内窥镜检查方式中,还有胃坑。AA-NF-NBI是分析隐窝开放和介入部分的最有效的内窥镜模式。
BACKGROUND: Conventional magnifying endoscopy with narrow-band imaging (NBI) observation of the gastric body mucosa shows dominant patterns in relation to the regular arrangement of collecting venules, subepithelial capillary network, and gastric pits.
OBJECTIVE: To evaluate the effectiveness of a new one-dual (near) focus, NBI mode in the assessment of the microscopic features of gastric body mucosa compared to conventional magnification.
METHODS: During 2021 and 2022, 68 patients underwent proximal gastrointestinal endoscopy using magnification endoscopic modalities subsequently applying acetic acid (AA). The GIF-190HQ series NBI system with dual focus capability was used for the investigation of gastric mucosa. At the time of the endoscopy, the gastric body mucosa of all enrolled patients was photographed using the white light endoscopy (WLE), near focus (NF), NF-NBI, AA-NF, and AA-NF-NBI modes.
RESULTS: The WLE, NF and NF-NBI endoscopic modes for all patients (204 images) were classified in the same order into three groups. Two images from each patient for the AA-NF and AA-NF-NBI endoscopic modes were classified in the same order. According to all three observers who completed the work independently, NF magnification was significantly superior to WLE (P < 0.01), and the NF-NBI mode was significantly superior to NF magnification (P < 0.01). After applying AA, the three observers confirmed that AA-NF-NBI was significantly superior to AA-NF (P < 0.01). Interobserver kappa values for WLE were 0.609, 0.704, and 0.598, respectively and were 0.600, 0.721, and 0.637, respectively, for NF magnification. For the NF-NBI mode, the values were 0.378, 0.471, and 0.553, respectively. For AA-NF, they were 0.453, 0.603, and 0.480, respectively, and for AA-NF-NBI, they were 0.643, 0.506, and 0.354, respectively.
CONCLUSIONS: When investigating gastric mucosa in microscopic detail, NF-NBI was the most powerful endoscopic mode for assessing regular arrangement of collecting venules, subepithelial capillary network, and gastric pits among the five endoscopic modalities investigated in this study. AA-NF-NBI was the most powerful endoscopic mode for analyzing crypt opening and intervening part.