窄带成像技术在结直肠增生性病变诊断中的临床应用价值  

Narrow-band imaging in diagnosis of colorectal hyperplasia lesions

作　　者：张丽[1] 郑斯杰[1] 张明[1] 杨丽芳[1] 陈金珍[1] 李海[1] 

机构地区：[1]江苏大学附属昆山市第一人民医院消化科,江苏昆山215300

出　　处：《实用临床医药杂志》2013年第A01期7-10,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨窄带成像内镜和染色内镜在结直肠增生性病变诊断中的临床应用价值。方法57例患者71处病灶分别在常规内镜、NBI内镜及靛胭脂染色内镜模式下进行观察，对病灶的大体轮廓、腺管开口及血管形态进行观察及分析，判别病灶为肿瘤性或非肿瘤性病灶，并将结果与病理诊断结果相比较。结果常规内镜检查发现病灶65处，检出率91．5％；NBI及靛胭脂染色内镜发现所有病灶，检出率100％。在病变轮廓和血管形态图像观察方面，NBI明显优于常规内镜和靛胭脂染色内镜：腺管开口形态图像显示NBI优于常规内镜，但与靛胭脂染色内镜无显著差别。NBI内镜判别结直肠肿瘤或非肿瘤性病变的病理符合率、敏感度、特异性分别为：91．5％（65／71）、81．8％（18／22）、95．9％（47／49）；与靛胭脂染色内镜88．7％（63／71）、77．3％（17／22）、93．9％（46／49）无显著差异；但明显优于常规内镜。结论NBI内镜对结直肠增生性病变，尤其是肿瘤性、非肿瘤性病变的鉴别优于常规内镜检查，与染色内镜相似能更为清晰地显示病变轮廓、腺管开口及微血管形态；可以及时鉴别增生性病变的性质、对指导活检、确定治疗策略均有非常重要的临床意义，对结直肠癌的早发现、早预防具有重要意义。Objective To evaluate the differential diagnostic value of narrow-band imaging（NBI） endoscopy and chromoendoscopy in diagnosis of colorectal hyperplasia lesions. Methods A total of 71 lesions form 57 patients were examined with conventional colonoscopy,NBI endoscopy and chromoendoscopy to evaluate lesions outlines,pit patterns and capillary patterns.The endoscopic findings were compared with the pathological diagnosis. Results The detection rate of conventional endoscopy was 91.5%（65/71）,which were 100%（71/71） for NBI endoscopy and chromoendoscopy. For the observation of outlines of lesions and CP, NBI is significant better than ordinary endoscope and there was no chromoendoscopy （P〈0.05）.While for the observation of PIT, significant difference between NBI and chromoendoscopy（p〉0.05）. The diagnostic accrracy rate,sensitivity and specificity of NBI were 91.5% （65/71）, 81.8% （18/22）, 95.9% （47/49）, which were not stastically significant compared with chromoendoscopy＇s 88.7%（63/71）, 77.3%（17/22）, 93.9%（46/49）. While there was significant difference between NBI and conventional colonoscopy. Conclusion NBI endoscopy is superior to conventional colonoscopy in diagnose of hyperplasia lesions of colorectal,especially in differentiation between neoplasm and non neoplasm. NBI advantages of which od that it can show the changes of silhouette of colorectal polypiod lesions,PIT and CP clearly.Also it is easy and convenient to switch, so that NBI is an effective technique to make early diagonosis ofcolorectal neoplasm and have important functions in prevention of colorectal cancer.

关 键 词：结直肠增生性病变 诊断 窄带成像技术 染色内镜 

分 类 号：R735.34[医药卫生—肿瘤]