Objective: To evaluate the clinical application of LASEREO endoscopic system in early gastric cancer (EGC). Methods: A total of 68 patients diagnosed with EGC were retrospectively analyzed between August 2017 to December 2020 in Fuding Hospital Affiliated to Fujian University of Traditional Chinese Medicine. There were 50 males and 18 females finally enrolled with a median age of 64 years. EGCs were analyzed from subjective and objective aspect, as well as from magnification and non-magnification status. Six endoscopists evaluated the visibility of the EGC (RSC) and calculated the color difference (ΔEC) between EGC and the surrounding mucosa in white light imaging (WLI), blue light imaging-bright (BLI-Bri) and linked color imaging (LCI) modes. In the case of magnification (×80), the visibility of the microstructures and microvessels (RSV) was analyzed and the color difference (ΔEV) between microvessels and non-vessels areas were calculated in WLI, BLI and LCI modes. The visibility was evaluated using visibility ranking scale(RS) and the color difference (ΔE) was calculated using L*a*b* color space. Results: In WLI, BLI-Bri, and LCI modes, the mean (±SD) RSC were 2.56±0.68, 2.63±0.59 and 3.17±0.50, and the mean(±SD) ΔEC were 15.71±5.58, 12.04±3.73, and 22.84±8.46, respectively, which in LCI were higher than those in WLI and BLI-Bri modes (P<0.001).Regarding the data evaluated by senior endoscopists, the RSC was higher in BLI-Bri than that in WLI mode (2.98±0.58 vs. 2.79±0.73, P<0.001), but as to those evaluated by junior endoscopists, there were no significant differences between the WLI and BLI-Bri modes(2.29±0.72 vs. 2.23±0.72,P =0.218).In magnifying endoscopy with WLI, BLI, and LCI modes, the mean(±SD) RSV were 2.95±0.28, 3.46±0.40, and 3.38±0.33, and the mean (±SD) ΔEV were 21.68±7.52, 44.29±10.94, and 45.38±14.29, respectively.The RSV and ΔEV in LCI and BLI were higher than that in WLI mode (P<0.001). Conclusions: LCI improves the visibility of EGC by increasing ΔEC, especially in junior endoscopists. Both BLI and LCI improve the visibility of microstructures and microvessels under magnification.
目的： 全面评估蓝激光内镜系统在早期胃癌（EGC）中的临床应用价值。 方法： 回顾性分析2017年8月至2020年12月就诊于福建中医药大学附属福鼎医院的68例连续性EGC患者，其中男性50例、女性18例，年龄45~78岁，中位年龄64岁。从主观和客观分析2个角度，以及放大和非放大状态2个方面分析。6名内镜医师先评估在非放大状态白光模式（WLI），联动成像模式（LCI）和亮蓝光成像模式（BLI-Bri）下EGC的可视性（RSC）并计算EGC与周边黏膜的色差（ΔEC），然后评估在放大状态（×80倍）WLI、LCI和蓝光成像模式（BLI）下EGC微结构的可视性（RSV）并计算微血管区与非血管区的色差（ΔEV）。可视性用可视性量表评估。色差是用L*a*b*颜色空间计算的。 结果： 在非放大状态WLI、BLI-Bri和LCI模式下，RSC平均值分别为（2.56±0.68）分、（2.63±0.59）分和（3.17±0.50）分，ΔEC平均值分别为15.71±5.58、12.04±3.73和22.84±8.46，LCI均高于BLI-Bri和WLI模式，差异均有统计学意义（P值均<0.001）。高年资医师组BLI-Bri模式下RSC高于WLI模式，差异有统计学意义［（2.98±0.58）分比（2.79±0.73）分，P<0.001］，而低年资医师组RSC在WLI和BLI-Bri模式之间差异无统计学意义［（2.29±0.72）分比（2.23±0.72）分，P=0.218］。在放大状态WLI、BLI和LCI模式下的RSV平均值分别为（2.95±0.28）分、（3.46±0.40）分和（3.38±0.33）分，ΔEV平均值分别为21.68±7.52、44.29±10.94和45.38±14.29，LCI和BLI模式均高于WLI模式，差异均有统计学意义（P值均<0.001），而LCI和BLI模式之间的差异无统计学意义。 结论： 非放大LCI模式明显增加EGC和周边黏膜的色差，提高EGC的可视性，可用于EGC的早期检测，尤其适合于低年资内镜医师。放大状态BLI和LCI模式均能增加微血管区和非血管区的色差，提高微结构可视性，可用于EGC的放大观察。.