窄带成像技术在结直肠肿瘤性与非肿瘤性病变诊断中的临床应用价值

摘要

Objective To evaluate the efficacy of narrow-band imaging(NBI) in diagnosis of colorectal neoplasms and non-neoplasms. Methods A total of 75 colorectal lesions in 60 patients detected by conventional colonoscopy from February 2010 to March 2011 were enrolled in the study. There were observed with conventional colonoscopy, NBI and chromoendoscopy. These lesions were classified by PIT pattern and capillary pattern(CP) , which was assessed by reference to histopathology. Results The diagnostic accuracy rate, sensitivity and specificity of NBI were 92. 0%, 92. 7%, 90. 0%, respectively. There was significant difference between NBI and conventional colonoscopy, while there was no significant difference between NBI and chromoendoscopy. For the observation of visualization of silhouette, pit and CP, NBI is better than ordinary endoscopc(P< 0.01). There was significant difference between NBI and chromoendoscopy in visualization of silhouette and CP(P<0. 01). However,no significant difference was detected between 2 methods in PIT(P>0. 05). The pathological evaluation diagnosed 19 cases of non-ncoplasms(including 8 cases of hypcrprolifcrativc polyps and 11 inflammatory polyps) and 56 cases of neoplasms (including 50 cases of adenoma and 6 cases of adenocarcinoma). Conclusions NBI is superior to conventional colonoscopy in differentiation between neoplasm and non- neoplasm. NBI advantages of which is that it can show the changes of silhouette of colorcctal polypiod lesions, PIT and CP clearly. NBI, easy and convenient to switch, is an effectiv technique to make early diagnosis of colorcctal neoplasm.%目的探讨内镜窄带成像技术(NBI)在结直肠肿瘤性及非肿瘤性病变诊断中的临床价值.方法选择2010年2月至2011年3月常规结肠镜检查发现的结直肠肿瘤性与非肿瘤性病变75个(60例).发现病变后分别采用常规模式、NBI模式及染色方法对病变轮廓、黏膜表面腺管开口(PIT)及微血管(CP)形态进行观察,与病理检查结果进行对比分析.结果 NBI内镜鉴别病变是否为肿瘤的准确性为92.0%、敏感性为92.7%、特异性为90.0%,与染色内镜相同,优于普通内镜.NBI与普通内镜对病变轮廓、PIT与CP图像清晰度比较差异均有统计学意义(P<0.01),NBI明显优于普通内镜.NBI与染色内镜对病变轮廓与CP的显示差异均有统计学意义(P<0.01),NBI优于染色内镜;两者在病变表面PIT的观察方面差异无统计学意义(P>0.05).组织病理学检查:非肿瘤性19个(增生性息肉8个,炎症性息肉11个);肿瘤性56个(腺瘤50个,腺癌6个).结论 NBI内镜对结直肠肿瘤性、非肿瘤性病变的鉴别优于常规内镜检查,与染色内镜相似.NBI内镜能更为清晰地显示病变轮廓、腺管开口及微血管形态.其操作转换简单快捷,便于全结肠观察,利于发现早期结直肠肿瘤.