国产分光内镜对结直肠微小息肉诊断价值的研究  

Diagnostic Value of Domestic Made Spectroscopic Endoscopy for Colorectal Diminutive Polyps

作　　者：谷硕 高云杰[1] 赵韫嘉[1] 龚帅[1] 陈海英[1] 李晓波[1] 戈之铮[1] GU Shuo;GAO Yunjie;ZHAO Yunjia;GONG Shuai;CHEN Haiying;LI Xiaobo;GE Zhizheng(Division of Gastroenterology and Hepatology,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai Institute of Digestive Disease,Shanghai 200001)

机构地区：[1]上海交通大学医学院附属仁济医院消化内科上海市消化疾病研究所,200001

出　　处：《胃肠病学》2018年第7期405-409,共5页Chinese Journal of Gastroenterology

基　　金：上海市科学技术委员会科研计划(13DZ1940403)

摘　　要：背景:结肠镜检出的结肠息肉中微小息肉所占的比例最高,国产分光内镜复合分光染色(CBI)内镜与窄带成像(NBI)技术同样具有分光染色功能。目的:探讨国产CBI内镜应用NICE分型诊断结直肠微小息肉的价值以及不同资质的内镜医师应用CBI技术的稳定性。方法:纳入2014年6月—2015年4月上海交通大学医学院附属仁济医院735例患者的707枚结直肠微小息肉,将患者随机分配至不同资质的内镜医师(NBI使用年限分别为5年、3年、2年)行CBI检查。根据病变的色泽、血管结构、表面结构判断NICE分型,并与病理结果进行比较,分析CBI内镜诊断结直肠微小息肉的价值以及不同资质的内镜医师应用CBI技术的稳定性。结果:国产CBI内镜诊断结直肠微小肿瘤性息肉的准确性、敏感性、特异性、阳性预测值和阴性预测值分别为83.6%、79.3%、86.7%、81.5%和85.1%;不同资质的内镜医师应用CBI技术诊断结直肠微小息肉的准确性无明显差异(P=0.07)。结论:国产CBI内镜对结直肠微小息肉的实时诊断具有良好的应用价值,且操作过程易于掌握。Background： The proportion of diminutive polyps is the highest in colon polyps detected by colonoscopy. Domestic made spectroscopic endoscopy compound band imaging（ CBI） had the same spectroscopic staining capability as that of narrow band imaging（ NBI）. Aims： To investigate the diagnostic value of domestic made CBI endoscopy via NICE classification for colorectal diminutive polyps and the stability of results of CBI endoscopy performed by endoscopists with different degree of NBI experience. Methods： A total of 707 colorectal diminutive polyps in 735 patients from June 2014 to April 2015 at Renji Hospital,School of Medicine,Shanghai Jiao Tong University were enrolled. Patients were randomly assigned into groups receiving CBI endoscopy performed by endoscopists with different degree of NBI experience（ 5 years,3 years,2 years,respectively）. NICE classification was defined according to color,vascular structure and surface structure of the lesion,and the results were compared with the pathological results. The diagnostic value of domestic made CBI endoscopy for colorectal diminutive polyps and the stability of CBI endoscopy results performed by endoscopists with different degree of NBI experience were analyzed. Results： The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of domestic made CBI endoscopy for diagnosis of colorectal diminutive polyps were 83. 6%,79. 3%,86. 7%,81. 5%,and 85. 1%,respectively. No significant difference in accuracy of CBI endoscopy for colorectal diminutive polyps was found among groups performed by endoscopists with different degree of NBI experience（ P = 0. 07）.Conclusions： Domestic made CBI endoscopy has excellent application value for the real-time diagnosis of colorectal diminutive polyps,and the procedure is easily to learn.

关 键 词：国产分光内镜 结直肠微小息肉 诊断 敏感性与特异性 

分 类 号：R735.34[医药卫生—肿瘤]