ABSTRACT
Objective To study the clinical value of hysteroscopy with narrow-band imaging (NBI) in diagnosis of different endometrial lesions. Methods 148 patients suffered from abnormal uterine bleeding with hysteroscopy examination and observed under hysteroscopy with ordinary white light and the NBI model respectively. Suspicious lesions targeted biopsy and gave pathological examination. With pathological diagnosis as a golden standard, it evaluated the value of hysteroscopy with NBI in different type of endometrial lesions. Results Low-risk type of endometrial lesions gave priority to type II microvascular and high-risk type of endometrial lesions gave priority to type III ~ IV microvascular. Sensitivity of low-risk endometrial lesions under white light and NBI modes was 65.52% and 86.21% respectively (χ2 = 6.78, P = 0.009), the difference was statistically significant in the two modes. The diagnosis of endometrial lesions low-risk type with NBI mode had medium consistency compared with the pathological diagnosis (Kappa value was 0.617). Under white light and the NBI modes, the accuracy rate of diagnosis in high-risk endometrial lesions was 81.08% and 89.86% respectively (χ2 = 4.60, P = 0.032), sensitivity was 57.14%and 92.86% respectively (χ2 = 14.29, P = 0.000), negative predictive value was 84.21% and 96.91% (χ2 = 9.43, P = 0.002), the difference was statistically significant in the two modes. The specificity was 90.57% and 88.68%respectively (χ2 = 0.20, P = 0.652), positive predictive value was 70.59% and 76.47% (χ2 = 0.37, P = 0.544). There was no significantly difference between the two modes. The diagnosis of endometrial lesions in high-risk pattern with NBI mode had good consistency with pathological diagnosis (Kappa value was 0.766). Conclusion NBI can observe mucosal surface and deep microvascular morphology clearly. It could reduce the missed diagnosis of low-risk type of endometrial lesions and improve the accuracy in diagnosis of high-risk type of endometrial lesions with NBI mode. NBI is a novel and valuable technique in the diagnosis of different endometrial lesions.