材料和方法

使用白光成像（WLI）和LCI对100名患者进行上消化道内镜检查。检查期间，内镜检查被视频记录下来。然后由四位内镜专家对其进行分析。他们回顾这些视频用于萎缩性胃炎、化生性胃炎、结节性胃炎和幽门螺杆菌感染的内镜诊断。用快速尿素酶试验进行组织活检以确认幽门螺杆菌感染状态和肠化生。

Materials and methods: Upper endoscopy was performed for 100 patients using white light imaging (WLI) and LCI. During the exam, endoscopic video was recorded. It was then analyzed by four expert endoscopists. They reviewed these videos for endoscopic diagnosis of atrophic gastritis, metaplastic gastritis, nodular gastritis and H. pylori infection. Tissue biopsies with rapid urease test were done to confirm H. pylori infection status and intestinal metaplasia.

结果

四名内镜医师之间观察者间变异性的Kappa值在白光组是一般到中等一致性。在LCI组是一般到高度一致性。白光诊断幽门螺杆菌感染的敏感性、特异性、阳性预测值和阴性预测值分别为32.4%、93.3%、85.2%和53.6%，而LCI组分别为57.4%、91.3%、88.7%和64.3%。使用白光/LCI诊断幽门螺杆菌的总诊断准确率为70.8%/78.8%。LCI诊断幽门螺杆菌感染的准确性和敏感性显著高于白光（两者均为p< .001）。然而，LCI和白光在诊断化生性胃炎的准确性、敏感性或特异性方面没有显著差异。

Results: Kappa values for the inter-observer variability among the four endoscopists were fair to moderate under WLI and fair to good under LCI. Sensitivity, specificity, positive predictive value and negative predictive value for diagnosing H. pylori infection using WLI were 32.4%, 93.3%, 85.2% and 53.6%, respectively, while those for LCI were 57.4%, 91.3%, 88.7% and 64.3%, respectively. Total diagnostic accuracies for diagnosing H. pylori infection using WLI/LCI were 70.8%/78.8%. The accuracy and sensitivity of LCI for diagnosing H. pylori infection were significantly higher than those of WLI (p < .001 for both). However, there were no significant differences in the accuracy, sensitivity or specificity for diagnosing metaplastic gastritis between LCI and WLI.