NBI-ME对病变表面微血管分型在诊断结直肠早期肿瘤中的意义  

Significance of Microvascular Pattern Classification by Narrow Band Imaging Combined with Magnifying Endoscopy in the Early Colorectal Tumors Diagnosis

作　　者：刘宇虎[1] 陈桂权[1] 钟东[2] 傅利萍[3] 陈晓春[1] 李志坚[1] 陈荣国[1] 张志坚[1] 柳娟[1] 

机构地区：[1]广东省东莞市人民医院消化科,523059 [2]南方医科大学中西医结合医院 [3]广东省东莞市人民医院病理科

出　　处：《医学研究杂志》2013年第1期72-75,共4页Journal of Medical Research

基　　金：广东省医学科学技术研究基金资助项目(B2005089);东莞市科技计划项目(2008105150018)

摘　　要：目的通过窄带成像放大内镜技术(NBI-ME)对结直肠病变表面微血管形态进行观察分型,研究NBI-ME对检出早期结直肠肿瘤性病变的价值。方法肠镜检查发现新生性病变后,用NBI-ME模式观察病变表面微血管形态并进行分型,所有病变均在内镜下切除或手术切除,将NBI-ME判断病变的性质与病理诊断结果比较。结果 NBI-ME在2115例患者中发现新生性病变2778个,MP-0型诊断为炎性息肉的准确率为97.4%,MP-Ⅰ型诊断为增生性息肉的准确率为93.3%,MP-Ⅱ型诊断为管状腺瘤准确率为97.2%,MP-Ⅲ型诊断为绒毛状腺瘤准确率为98.3%,MP-Ⅳ型诊断为绒毛状-管状腺瘤准确率为94.5%,MP-Ⅴ型诊断为高级别上皮内瘤变准确率为96.9%,MP-Ⅵ型诊断为黏膜内癌准确率为90.9%,MP-Ⅶ型诊断为浸润癌准确率为88.0%,MP-Ⅷ型诊断为进展期癌准确率为100.0%。NBI-ME对病变表面微血管形态判断肿瘤性病变的准确性为98.8%,敏感度为99.2%,特异性为94.9%。结论 NBI-ME内镜技术病变表面微血管形态分型,对判断病变是否是肿瘤性病变的准确率高,对早期结直肠肿瘤或结直肠癌的病理诊断预测准确率高,NBI-ME将成为发现结直肠早期肿瘤的更有效的内镜检查方法。Objective To classify the microvascular patterns（MP） on the surface of colorectal lesion or tumor with the technique of Narrow Band Imaging combined with Magnifying Endoscopy （NBI -ME） , and explore the potential clinical significance of MP classification in the early colorectal tumors diagnosis. Methods With NBI - ME technique, the MP on the surface of colorectal neogenesis lesions were recorded and classified. All of the neogenesis lesions were resected endoscopicaily or by surgery. The data achieved by NBI - ME were compared with histopathology diagnosis to assess the accuracy, sensitivity and specificity of NBI- ME on the early colorectal tumors diagnosis. Results A total of 2778 neogenesis lesions were detected in 2115 patients by NBI - ME,which were classified to 9 subtypes from type MP -0 to type MP -VIII. Compared with histopathology diagnosis, we found 97.4% of MP -0 fall into inflammatory polyps. Moreover, 93.3% of MP- Ⅰ , 97.2% of MP - Ⅱ , 98.3% of MP- Ⅲ, 94.5% of MP- Ⅳ, 96.9% of MP- Ⅴ , 90.9% of MP-Ⅵ, 88.0% of MP - Ⅶ and 100.0% of MP - Ⅷfall into proliferative polyps, tubular adenoma, villous adenoma, villous -tubular adenoma, high- grade adenoma, intramucosal carcinoma, slightly invaded submucosal cancer and advanced cancer respectively. Taken together, the accuracy, sensitivity, specificity of the microvascular patterns （MP） by NBI - ME on the colorectal tumors diagnosis was 98.8% , 99.2% and 94.9% respectively. Conclusion The diagnostic accuracy of MP classification by NBI - ME technique was significantly higher, it is a prospective strategy for early colorectal tumors.

关 键 词：结直肠 肿瘤 窄带成像 放大内镜 微血管形态 

分 类 号：R692[医药卫生—泌尿科学]