Abstract:

Objective　To analyze the value of magnifying endoscopy combined with blue laser imaging (M-BLI) and the albumin to alkaline phosphatase ratio (AAPR) in the diagnosis of esophageal cancer. Methods　From March 2022 to December 2023, 92 patients suspected with esophageal cancer taking examination at Ankang People's Hospital were selected, including 49 males and 43 females who were (51.27±15.19) years old. All the patients underwent pathological histological examination as the gold standard. Before the pathological examination, the patients underwent conventional white light endoscopy, M-BLI, and blood AAPR test in succession. The accuracy of M-BLI combined with AAPR in the diagnosis of esophageal cancer was evaluated. t test and Kappa test were used. A receiver operating characteristic curve (ROC) was plotted to assess the diagnostic value. Results　Among the 92 patients, 38 (41.30%) were diagnosed with early esophageal cancer, and 54 (58.70%) with non-neoplastic lesions via pathological examination. The positive predictive value, negative predictive value, accuracy, and Kappa value of M-BLI in the diagnosis of esophageal cancer were 78.05%, 88.24%, 83.70%, and 0.668. The AAPR's in the esophageal cancer group and the non-neoplastic lesion group were (0.57±0.14) and (0.69±0.21), respectively, with a statistical difference (t=3.072, P=0.003). The sensitivities of M-BLI, AAPR, and their combination for diagnosing esophageal cancer were 0.84, 0.72, and 0.84, respectively; the specificities were 0.83, 0.79, and 0.85, respectively; the areas under the curves were 0.835 (95%CI 0.770-0.901), 0.795 (95%CI 0.725-0.864), and 0.893 (95%CI 0.843-0.944), respectively. Conclusions　M-BLI combined with AAPR can be used for diagnosing esophageal cancer, with a high diagnostic accuracy.

Key words:

Esophageal cancer, Blue laser imaging, Magnifying endoscopy, Albumin to alkaline phosphatase ratio, Diagnosis

摘要：

目的　探讨蓝激光成像结合放大内镜（magnifying endoscopy combined with blue laser imaging，M-BLI）、白蛋白与碱性磷酸酶比值（albumin-to-alkaline phosphatase ratio，AAPR）诊断食管癌的价值。方法　选取2022年3月至2023年12月在安康市人民医院检查时疑似食管癌的患者92例，男49例，女43例，年龄（51.27±15.19）岁。所有患者均以病理组织学检查为金标准。病理检查前依次行常规白光内镜检查、M-BLI检查及血AAPR检测。评价M-BLI联合AAPR诊断食管癌的准确率。采用t检验、Kappa检验。绘制受试者操作特征曲线（receiver operating characteristic curve，ROC）评估诊断价值。结果　92例患者经病理诊断确诊早期食管癌38例（41.30%），非瘤性病变54例（58.70%）。M-BLI诊断食管癌的阳性预测值为78.05%，阴性预测值为88.24%，准确率为83.70%，一致性Kappa值为0.668。食管癌组和非瘤性病变组AAPR分别为（0.57±0.14）、（0.69±0.21），差异有统计学意义（t=3.072，P=0.003）。M-BLI、AAPR单一及联合诊断食管癌的灵敏度分别为0.84、0.72、0.84，特异度分别为0.83、0.79、0.85，曲线下面积分别为0.835（95%CI 0.770～0.901）、0.795（95%CI 0.725～0.864）、0.893（95%CI 0.843～0.944）。结论　M-BLI联合AAPR可用于诊断食管癌，且诊断准确率较高。

关键词:

食管癌, 蓝激光成像, 放大内镜, 白蛋白与碱性磷酸酶比值, 诊断