放大内镜窄带成像联合高频腔内超声微探头在大肠广基型/侧方发育型病变微创诊疗中的应用价值  

Value of ME-NBI and HFMPS for preoperative-evalution of colorectal lateral spreading and sessile tumor

作　　者：任大宾[1] 徐萍[1] 徐凯[1] 王静[1] 

机构地区：[1]上海市松江区中心医院消化内科,上海201600

出　　处：《临床消化病杂志》2016年第3期137-140,共4页Chinese Journal of Clinical Gastroenterology

基　　金：上海市松江区科学技术攻关项目(No:12SJGGYY03)

摘　　要：[目的]探讨联合应用放大内镜窄带成像技术(magnifying endoscopy with narrow-band imaging,MENBI)及高频超声微探头(high-frequency mini-probe sonography,HFMPS))对大肠广基型/侧方发育型病变进行术前评估及微创诊疗中的应用价值。[方法]对行结肠镜检查发现大肠广基型/侧方发育型病变且符合入选标准的73例患者,联合应用ME-NBI及HFMPS进行术前评估,根据Sano微血管形态分型及超声内镜对病变浸润深度的判断,将病变浸润深度分为黏膜内或黏膜下层上1/3(m/sm1)和黏膜下层中1/3及以上(>sm2),并对照术后病理对其判断准确性做出判断。[结果]73例患者中腺瘤54例,大肠癌19例(8例m/sm1癌、11例>sm2)。ME-NBI及HFMPS对70例患者做出了准确的判断,判断的准确度95.89%、灵敏度90.91%、特异度96.77%、阳性预测值83.33%、阴性预测值98.36%。[结论]ME-NBI联合HFMPS对于大肠广基型/侧方发育型病变的术前评估有着良好的应用价值,有助于选择合适的治疗方案,避免不恰当的治疗。[Objective]To evaluate the role of magnifying endoscopy with narrow-band imaging（ME- NBI）and high-frequency mini-probe sonography（HFMPS）in the preoperative-evalution of colorectal lateral spreading and sessile tumor. [Methods]From August 2012 to August 2015 ,patients with spreading and ses- sile colorectal tumor who met inclusion criteria were enrolled in this study. ME-NBI and HFMPS examina- tions were performed to evaluate the depth of tumor invasiveness. The invasive depth was determined as m/ sml or%sm2 based on Sano＇ capillary patterns and HFMPS results. [Results]Seventy-three patients met in- clusion criteria,54 cases were diagnosed as adenoma and 19 cases were diagnosed as adenocarcinoma（8 ca- ses of m/sml and 11 cases of 〉sm2）. The overall accuracy rate for ME-NBI and HFMPS was 95.89% ,the sensitivity, specificity, positive predictive value and negative predictive value were 90.91%, 96. 77%, 83.33 % and 98. 36 %, respectively. [Conclusion]The combination of ME-NBI and HFMPS is very useful for preoperative-evalution of colorectal lateral spreading and sessile tumor. Precise assessment of invasive depth caused by colorectal lateral spreading and sessile tumor is essential for the choice of optimal treat- ment method.

关 键 词：大肠癌 放大内镜 窄带成像 癌前病变 内窥镜超声检查 

分 类 号：R735.34[医药卫生—肿瘤]