Objective To investigate the application value of narrow band imaging combined with magnifying endoscopy (NBI-ME) in the diagnosis of early carcinoma and precancerous lesions of gastrointestinal tract in elderly patients.Methods Eight hundred and twenty four elderly patients examed by NBI-ME were selected as the observation group and 815 patients examed by routine gastrointestinal endoscopy were selected as the control group.The detection rates of advanced carcinoma,early carcinoma,precancerous lesions of gastrointestinal tract in the two groups were observed and compared.Results The detection rates of early carcinoma,precancerous lesions of gastrointestinal tract in patients of observation group were significantly higher than those in control group (χ2=4.715,6.500.P<0.05).The sensitivities of NBI-ME examination in the diagnosis of early carcinoma,precancerous lesions of gastrointestinal tract were significantly higher than those of routine gastrointestinal endoscopy examination (χ2=5.916,10.471.P<0.05).The Youden index and the consistency coefficient (kappa) compared with pathological biopsy results were significantly higher than those of routine gastrointestinal endoscopy examination,but there were no statistically significant differences (χ2=0.985,1.031.P>0.05).Conclusion The sensitivity and detection rate of NBI-ME in the diagnosis of early carcinoma,precancerous lesions of gastrointestinal tract are higher and can be used as a effective clinical diagnostic measures.%目的 了解窄带成像放大内镜(NBI-ME)在诊断老年消化道早癌及癌前病变中的应用价值.方法 选取824例行NBI-ME检查的老年患者作为观察组,选取815例行常规胃肠镜检查的老年患者作为对照组.对两组消化道进展期癌、早癌及癌前病变的检出率进行观察和比较.结果 观察组患者中消化道早癌检出率[13例(1.6%)比4例(0.5%),χ2=4.715,P=0.030]和癌前病变的检出率[22例(2.7%)比8例(1.0%),χ2=6.500,P=0.011]显著高于对照组,NBI-ME检查诊断消化道早癌灵敏度[10例(76.9%)比3例(27.3%),χ2=5.916,P=0.015]和癌前病变的灵敏度[19例(79.2%)比7例(31.8%),χ2=10.471,P=0.001]显著高于常规胃肠镜,其Youden指数及与组织病理活检结果比较的一致性系数(Kappa值)均显著高于常规胃肠镜,但特异度的差异无统计学意义(χ2=0.985、1.031,P>0.05).结论 NBI-ME消化内镜检查在诊断消化道早癌和癌前病变方面具有较高的灵敏度和检出率.
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