京都胃炎分类评分结合醋酸-靛胭脂染色放大内镜对早期胃癌的诊断价值

doi:10.3969/j.issn.1671-7171.2025.02.025

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摘要【目的】探讨京都胃炎分类评分(KCS)结合醋酸-靛胭脂染色放大内镜对早期胃癌的诊断价值。【方法】行内镜黏膜下剥离术(ESD)的98例早期胃癌患者为观察组,57例因腹胀、腹痛等上腹部不适拟行内镜检查的非胃癌患者为对照组,将所有患者按照KCS分为低分组(n=79,＜4分)与高分组(n=76,≥4分)。比较观察组与对照组的临床资料和KCS,比较高分组与低分组胃癌占比。筛查早期胃癌发生的影响因素,制作受试者工作特征(ROC)曲线,以曲线下面积(AUC)评估相关指标的诊断价值。【结果】观察组KCS高于对照组(P<0.05)。高分组胃癌占比高于低分组(P<0.05)。醋酸-靛胭脂染色放大内镜共检出早期胃癌81例,剩余17例为非胃癌,其中异型增生6例、肠上皮化生11例。观察组胃蛋白酶原(PG)Ⅰ/PGⅡ低于对照组(P<0.05)。有幽门螺杆菌(HP)尿素酶抗体、糖类抗原125(CA125)、糖类抗原199(CA199)、癌胚抗原(CEA)、PGⅠ/PGⅡ、KCS为早期胃癌发生的影响因素(P<0.05)。KCS、醋酸-靛胭脂染色放大内镜及二者联合诊断早期胃癌的AUC值分别为0.820、0.852、0.882,二者联合的AUC值更高(P<0.05)。【结论】KCS、醋酸-靛胭脂染色放大内镜可用于诊断早期胃癌,且二者联合检测具有更高的诊断价值。

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	门中俊
	刘赟
	贾会文

关键词 ：胃肿瘤, 内窥镜检查, 胃肠道, 诊断,鉴别

Abstract：【Objective】To explore the diagnostic value of the Kyoto Classification of Gastritis (KCS) score combined with acetic acid-indigo carmine staining magnification endoscopy in early gastric cancer.【Methods】Ninety-eight early gastric cancer patients who underwent endoscopic submucosal dissection (ESD) were included in the observation group, and 57 non-cancer patients who were scheduled for endoscopy due to upper abdominal discomfort (such as bloating and pain) were included in the control group. According to the KCS, patients were divided into the low-score group (n=79, <4 points) and the high-score group (n=76, ≥4 points). Clinical data and KCS scores of the observation group and the control group were compared, and the proportion of gastric cancer cases in the high-score group and the low-score score groups were compared as well. Factors influencing early gastric cancer occurrence were screened, and receiver operating characteristic (ROC) curves were generated to assess the diagnostic value using the area under the curve (AUC).【Results】The KCS score in the observation group was significantly higher than that in the control group (P<0.05). The proportion of gastric cancer cases in the high-score group was significantly higher than that in the low-score group (P<0.05). Acetic acid-indigo carmine staining magnification endoscopy detected 81 cases of early gastric cancer and 17 non-cancer cases (6 cases with atypical hyperplasia and 11 cases with intestinal metaplasia). The pepsinogen (PG)Ⅰ/PGⅡ ratio in the observation group was lower than that in the control group (P<0.05). Helicobacter pylori (HP) urease antibody, carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199), carcinoembryonic antigen (CEA), PGⅠ/Ⅱ, and KCS were identified as factors related to early gastric cancer occurrence (P<0.05). The AUC values for KCS, acetic acid-indigo carmine staining magnification endoscopy, and their combined use in diagnosing early gastric cancer were 0.820, 0.852, and 0.882, respectively, with the combined approach showing a higher AUC value (P<0.05).【Conclusion】KCS and acetic acid-indigo carmine staining magnification endoscopy are effective in diagnosing early gastric cancer, while the combination of the two methods provides even higher diagnostic value.

Key words： Stomach Neoplasms Endoscopy, Gastrointestinal Diagnosis, Differential

收稿日期: 2024-09-14

中图分类号:

R735.2

引用本文:

门中俊, 刘赟, 贾会文. 京都胃炎分类评分结合醋酸-靛胭脂染色放大内镜对早期胃癌的诊断价值[J]. 医学临床研究, 2025, 42(2): 261-264.
MEN Zhongjun, LIU Yun, JIA Huiwen. Diagnostic Value of Kyoto Classification of Gastritis Score Combined with Acetic Acid-Indigo Carmine Staining Magnification Endoscopy in Early Gastric Cancer. JOURNAL OF CLINICAL RESEARCH, 2025, 42(2): 261-264.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.02.025 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I2/261

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