窄带成像技术联合放大内镜与胃镜活检诊断早期胃癌的价值比较

Well-differentiated adenocarcinoma may be misdiagnosed as gastritis cystica profunda

Gastric cancer (GC) is one of the most common malignant tumors in China. The low detection rate of early GC is one of the reasons for its high mortality rate. Thanks to the application of new gastroscopy technology, the detection rate of early GC has increased. Highly differentiated adenocarcinoma accounts for about 70% of all early GC cases; however, well-differentiated adenocarcinoma is difficult to diagnose because of its non-significant structural abnormality and cellular atypia. Gastritis cystica profunda is a rare disease characterized by the presence of the gastric intrinsic gland in the muscularis mucosa and/or submucosa, which is easily confused with highly differentiated adenocarcinoma. Therefore, attention should be paid to the identification of these two different entities in the clinical work.

Value of flexible spectral imaging color enhancement combined with magnifying endoscopy in diagnosis of early gastric cancer

AIM

To evaluate the value of flexible spectral imaging color enhancement (FICE) combined with magnifying endoscopy in the diagnosis of early gastric cancer.

METHODS

Patients with suspected early gastric cancer who underwent FICE combined with magnifying endoscopy from March 2015 to December 2015 were retrospectively analyzed. The endoscopic diagnosis criteria for early gastric cancer were made according to the microstructure, microvascular and demarcation line. Finally, the accuracy of FICE combined with magnifying endoscopy for the diagnosis of early gastric cancer was assessed by comparing with pathological results.

RESULTS

Of 177 lesions that underwent FICE and magnifying endoscopy, 26 were pathologically diagnosed as low grade intraepithelial neoplasia, 12 as high grade intraepithelial neoplasia, and 139 as non-cancer lesions. The sensitivity, specificity and Youden index of FICE combined with magnifying endoscopy were 68.4%, 87.8% and 56.2% for intraepithelial neoplasia, and 75.0%, 100% and 75.0% for early gastric cancer, respectively.

CONCLUSION

FICE combined with magnifying endoscopy can improve the diagnostic accuracy for early gastric cancer.

Comparison of two types of biopsy forceps in gastroscopic biopsy for chronic gastritis

AIM: To compare the sampling effect and pathological results of two biopsy forceps in the endoscopic biopsy for chronic gastritis.

METHODS: One hundred and thirty chronic gastritis patients hospitalized at the First Hospital of Zibo City from July of 2013 to July of 2014 were included and divided into groups A and B, with 65 cases in each. Group A underwent gastroscopy and biopsy with needle-free stomach forceps, and group B underwent gastroscopy and biopsy with needle forceps. The sampling effect and pathological results were compared between the two groups.

RESULTS: With regard to the sampling effect, the rates of satisfaction to sampling effect at the greater curvature of the stomach and gastric antrum were 80% and 76.9%, respectively, in group A, which were significantly lower than those (92.3% and 90.7%) in group B (P < 0.05). A comparison of the pathological results of the tissues collected from groups A and B with the final pathological results revealed that the pathological diagnostic accuracy and final pathological diagnostic accuracy were 61.5% and 72.3%, respectively, for superficial gastritis and 30.7% and 46.2% for atrophic gastritis in group A (P > 0.05). The corresponding percentages in group B were 69.2% and 72.3% for superficial gastritis and 43.1% and 46.2% for atrophic gastritis (P > 0.05). There were no significant differences between groups A and B (P > 0.05).

CONCLUSION: For endoscopic biopsy in patients with chronic gastritis, the type of biopsy forceps is related to sampling effect, but not to pathological results. Needle biopsy forceps are better needle-free stomach biopsy forceps.