放大色素肠镜鉴别诊断大肠小息肉及其癌变  

Distinguishing colorectal minute polyps and canceration by magnifying endoscopy. with mucosal methylene blue dye spraying

作　　者：翁雪健[1] 郑亮[2] 

机构地区：[1]浙江省温州医学院 [2]浙江省温州市第三人民医院消化内科,325000

出　　处：《重庆医学》2005年第4期543-544,共2页Chongqing medicine

摘　　要：目的　探讨放大色素肠镜结合Kudo腺管分型对发现病变及鉴别小息肉性质的意义。方法　经放大电子肠镜结合亚甲蓝染色对80例直径≤10mm的小息肉进行形态学和组织学对照研究。结果　“超微小息肉”(直径≤0.3cm)占42.5%(34/80),无蒂型达97.1%(33/34),应用放大色素肠镜结合Kudo腺管分型对非瘤性息肉诊断敏感性为92.5 %,诊断特异性为96.1%。对瘤性息肉诊断敏感性为92.3%,特异性为82.8%。2例息肉癌变,均为V型表现, 2例手术后的吻合口息肉,表现为V型开口,病理证实为肉芽肿病变。结论　放大色素肠镜能发现小息肉,特别是“超微小息肉”,染色法结合Kudo分型鉴别诊断预测病变的性质,指导内镜下的合理处理。Objective To find and distinguish colorectal minute polyps by magnifying endoscopy with mucosal methylene blue dye spraying according to Kudo′s Pit pattern modified classification.Methods Eighty patients with colorectal polyps ≤10mm in diameter were studied morphologically and histologically by magnifying endoscopy with mucosal methylene blue dye spraying.Results 'Ultra-mini polyps'(≤0.3cm in diameter) was 42.5%(34/80), sessile polyps was 97.1%(33/34).The accuracy of diagnosis of neoplastic and non-neoplastic polyps by magnifying endoscopy with mucosal methylene blue dye spraying was 92.3% and 92.5 % respectively and specificity was 82.8% and 96.1% respectively.Two polyps with V pit pattern were happened canceration, 2 polyps with V pit pattern proved to be granuloma in histologically.Conclusions The magnifying endoscopy with mucosal methylene blue dye spraying can find minute polyp ,especially ultra-mini polyps. It can differentiate the character of polyps and help in decision making during colonoscopy.

关 键 词：放大电子肠镜 亚甲蓝 肠息肉 腺管开口 

分 类 号：R735.34[医药卫生—肿瘤]