Application value of endoscopic narrow-band imaging technology in the diagnosis of early gastric cancer under the background of Hp infection

doi:10.3877/cma.j.issn.2095-2015.2025.01.006

Abstract

Abstract:

Objective

To study the application value of endoscopic narrow-band imaging (NBI)in the diagnosis of early gastric cancer under the background of Helicobacter pylori (Hp) infection.

Methods

A total of 82 patients with early gastric cancer admitted to Jiaozhou Central Hospital of Qingdao from January 2022 to December 2022 were retrospectively selected and divided into Hp infection group (n=54) and Hp eradication group (n=28) according to Hp detection results. All patients underwent white light endoscopy and NBI examination, the white light endoscopy and NBI findings of patients with early gastric cancer in Hp infection group and Hp eradication group were compared, the image quality scores of white light endoscope and NBI were compared, the receiver's working curve (ROC) was drawn to analyze the diagnostic value of endoscopy in Hp eradicated early gastric cancer, and the diagnostic results of white light endoscopy and NBI in patients with early gastric cancer under different Hp conditions were compared.

Results

The rates of white light endoscope diffused redness and lesion depression in Hp infection group were significantly higher than those in Hp eradication group, the rate of boundary ambiguity in Hp infection group was significantly lower than that in Hp eradication group, there were statistically significant differences (P＜0.05); there were no statistically significant differences in the rates of boundary irregularity and shrinkage between the two groups (P＞0.05). The diagnostic rate of early gastric cancer in the Hp eradication group was lower than that in the Hp infection group (P＜0.05), and the diagnostic rate of early gastric cancer in the NBI group was higher than that in the white light endoscope group (P＜0.05). The microvascular morphology, gastric fovea morphology and lesion contour scores of NBI were significantly higher than those of white light endoscopy (P＜0.05). ROC analysis showed that the areas under the curve of white light endoscopy and NBI for the diagnosis of early gastric cancer in the Hp eradication group were 0.571 and 0.657, with specificity of 74.41% and 90.52% and sensitivity of 78.54% and 97.45%.

Conclusion

NBI can improve the diagnosis of early gastric cancer under the background of Hp infection, and Hp eradication can affect the endoscopic diagnosis of early gastric cancer.

Key words: Stomach, Canceration, Helicobacter pylori, Narrow-band imaging technology, Endoscopy, Diagnostic value

Fangfang Li, Xiaohong Liu, Yanbin Sun. Application value of endoscopic narrow-band imaging technology in the diagnosis of early gastric cancer under the background of Hp infection[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2025, 15(01): 29-33.

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URL: https://zhxhbyyxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-2015.2025.01.006

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Figures/Tables 8

组别	例数	性别[例(%)]		年龄(岁, $\bar{x}$ ±s)	肿瘤大小(mm, $\bar{x}$ ±s)	肿瘤位置[例(%)]
组别	例数	女	男	年龄(岁, $\bar{x}$ ±s)	肿瘤大小(mm, $\bar{x}$ ±s)	上段	中段	下段
Hp感染组	54	34(62.96)	20(37.04)	55.98±7.45	13.03±3.18	3(5.56)	32(59.26)	19(35.18)
Hp根除组	28	18(64.29)	10(35.71)	56.18±7.03	12.75±3.51	1(3.57)	20(71.43)	7(25.00)
χ ²/t值		0.014		0.117	0.365	1.183
P值		0.906		0.907	0.716	0.554

组别	例数	性别[例(%)]		年龄(岁, $\bar{x}$ ±s)	肿瘤大小(mm, $\bar{x}$ ±s)	肿瘤位置[例(%)]
组别	例数	女	男	年龄(岁, $\bar{x}$ ±s)	肿瘤大小(mm, $\bar{x}$ ±s)	上段	中段	下段
Hp感染组	54	34(62.96)	20(37.04)	55.98±7.45	13.03±3.18	3(5.56)	32(59.26)	19(35.18)
Hp根除组	28	18(64.29)	10(35.71)	56.18±7.03	12.75±3.51	1(3.57)	20(71.43)	7(25.00)
χ ²/t值		0.014		0.117	0.365	1.183
P值		0.906		0.907	0.716	0.554

组别	例数	白光内镜表现					白光内镜诊断结果	NBI表现			NBI诊断结果
组别	例数	弥散样发红	病变凹陷	边界不清	边界不规则	萎缩	白光内镜诊断结果	微结构紊乱	微血管紊乱	明显边界线	NBI诊断结果
Hp感染组	54	45(83.33)	53(98.15)	15(27.78)	50(92.59)	52(96.30)	37(68.52)	40(74.07)	49(90.74)	44(81.48)	53(98.15)^#
Hp根除组	28	7(25.00)	8(28.57)	27(96.43)	25(89.29)	24(85.71)	12(42.86)	7(25.00)	6(21.43)	4(14.29)	24(85.71)^#
χ ²值		27.044	46.854	34.781	0.258	3.045	5.049	18.151	40.111	34.303	4.979
P值		0.000	0.000	0.000	0.611	0.081	0.025	0.000	0.000	0.000	0.026

组别	例数	微血管形态	胃小凹形态	病变轮廓
白光内镜	82	2.17±0.46	2.61±0.39	2.35±0.41
窄带成像技术	82	3.34±0.21	3.57±0.23	3.18±0.29
t值		20.952	19.200	14.966
P值		0.000	0.000	0.000

指标	面积	SE	sig	95%CI	特异度	敏感度
白光内镜	0.571	0.074	0.333	0.466～0.726	74.41	78.54
窄带成像技术	0.657	0.070	0.033	0.519～0.803	90.52	97.45

组别	例数	白光内镜	窄带成像技术
Hp感染组	54	37(68.52)	53(98.15)^#
Hp根除组	28	12(42.86)	24(85.71)^#
χ ²值		5.049	4.979
P值		0.025	0.026

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