窄带成像技术普通内镜与放大内镜对大肠肿瘤诊断价值的对比研究  

A comparative study of narrow-band imaging （NBI） with routine endoscopy and NBI with magnifying endoscopy for the diagnosis of colorectal neoplasia

作　　者：周晴接[1] 杨建民[1] 费保莹[1] 阮洪军[1] 徐启顺[1] 柯进晶[1] 吴伟权[1] 

机构地区：[1]浙江省人民医院消化内科,杭州市310014

出　　处：《中华消化内镜杂志》2011年第1期13-16,共4页Chinese Journal of Digestive Endoscopy

基　　金：基金项目：浙江省科技厅资助项目（No.2009C33082）

摘　　要：目的 探讨窄带成像技术（NBI）模式下普通内镜和放大内镜对大肠肿瘤性与非肿瘤性病变的鉴别诊断价值.方法 选择2008年9月至2010年2月间内镜中心行NBI内镜检查发现的大肠新生性病变的患者,对发现的大肠新生性病变进行黏膜表面细微腺管开口形态分型及微血管形态分型,综合工藤进英腺管开口形态分型法与佐野宁微血管形态分型法进行诊断,将NBI内镜诊断结果与病理诊断结果进行对比分析.100例患者符合条件纳入研究,其中行NBI普通内镜64例,行NBI放大内镜36例.结果 排除不符合诊断标准的7例病例（NBI普通内镜5例,NBI放大内镜2例）,NBI内镜对大肠肿瘤性与非肿瘤性病变诊断的总符合率为91.4%（85/93）,其中NBI普通内镜为89.8%（53/59）,NBI放大内镜为94.1%（32/34）,均明显高于文献报道传统内镜的79.1%（P均＜0.05）,但NBI普通内镜与NBI放大内镜间比较差异无统计学意义（P＞0.05）.结论 与NBI放大内镜相似,NBI普通内镜也可比较准确地鉴别大肠肿瘤性与非肿瘤性病变.Objective To compare the diagnostic efficacies of narrow-band imaging （NBI） in distinguishing neoplastic from non-neoplastic colorectal lesions with routine endoscopy and with magnifying endoscopy. Methods Patients with colorectal lesions detected by NBI from September 2008 to February 2010 were enrolled in the study. These lesions were classified by pit pattern and capillary pattern, which was then assessed by reference to histopathology. Results A total of 100 patients with colorectal lesions were enrolled, and the lesions were observed by NBI with ordinary endoscopy （n =64） and NBI with magnifying endoscopy （n =36）, respectively, and 7 cases （5 in NBI with ordinary endoscopy and 2 in NBI with magnifying endoscopy） which did not meet the diagnostic criteria were excluded. The overall diagnostic accuracy of NBI endoscopy in distinguishing neoplastic from non-neoplastic colorectal lesions was 91.4% （ 85/93 ）, in which NBI with ordinary endoscopy and magnifying endoscopy was 89. 8% （53/59） and 94. 1% （32/34）,respectively, with both significantly higher than that of conventional colonoscopy reported in the literature （79. 1% ） （P 〈 0. 05 ）. However, no significant difference was detected between 2 methods （ P 〉 0. 05 ）.Conclusion Similar with NBI magnifying endoscopy, NBI endoscopy without high magnification may also be useful to distinguish neoplastic from non-neoplastic colorectal lesions.

关 键 词：结肠肿瘤 内窥镜检查 窄带成像技术 诊断 

分 类 号：R735.34[医药卫生—肿瘤]