蓝光成像结合NICE分型对结直肠侧向发育型肿物的诊断价值  

The diagnostic performance of blue laser imaging combined NICE classification for colorectal laterally spreading tumors

作　　者：彭群[1] 黄颖[1] 彭阳[1] 周蕴 赖吉凤 乔伟光[1] 谭文欣[1] PENG Qun;HUANG Ying;PENG Yang;ZHOU Yun;LAI Ji-feng;QIAO Wei-guang;TAN Wen-xin(Department of Gastroenterology, Guangdong Provincial Key Laboratory of Gastroenterology, Institute of Gastroenterology of Guangdong Province, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province)

机构地区：[1]南方医科大学南方医院消化内科,广东省南方消化疾病研究所,广东省消化疾病重点实验室,510515

出　　处：《现代消化及介入诊疗》2020年第5期572-575,580,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：广东省卫生健康适宜技术推广项目(201905220936166374);广东省研究生教育创新计划项目(2019XSLT13)。

摘　　要：目的探讨蓝光成像(BLI)结合NICE分型对结直肠侧向发育型肿物(LSTs)的诊断价值。方法对肠镜检查发现的172处结直肠侧向发育型肿物进行BLI观察,观察病灶表面的颜色、血管以及腺管开口,根据NICE分型预测病变的性质,与内镜下切除或外科手术后的病理结果进行对比分析。结果NICE 1型诊断HP或SSP的敏感度、特异度、阳性预测值(PPV)、阴性预测值(NPV)、准确率分别为33.3%、98.8%、50.0%、97.6%和96.5%。NICE 2型诊断LGD、HGD及m-SMs的敏感度、特异度、PPV、NPV、准确率分别为96.9%、50.0%、96.3%、54.5%和93.6%。NICE 3型诊断SMd的敏感度、特异度、PPV、NPV、准确率分别为75.0%、97.6%、42.9%、99.4%和97.1%。结论BLI结合NICE分型可较好的区分结直肠肿瘤性LSTs和非肿瘤性LSTs,对于结直肠LSTs的浸润深度判断良好,可以指导治疗策略选择。Objective To investigate the diagnostic efficacy of blue laser imaging in distinguishing neoplastic from non-neoplastic colorectal laterally spreading tumors,using NICE(NBI international colorectal endoscopy)classification system.Methods A total of 172 colorectal laterally spreading tumors were enrolled in this study.Each lesion was observed by blue light imaging and the histology was predicted according to NICE classification system.The results were compared with histologic findings.Results The diagnostic sensitivity,specificity,PPV,NPV and accuracy of Type 1 were 33.3%,98.8%,50.0%,97.6%,and 96.5%,respectively.The diagnostic sensitivity,specificity,PPV,NPV and accuracy of Type 2 were 96.9%,50.0%,96.3%,54.5%,and 93.6%,respectively.The diagnostic sensitivity,specificity,PPV,NPV and accuracy of Type 3 were 75.0%,97.6%,42.9%,99.4%,and 97.1%,respectively.Conclusion Blue laser imaging combined NICE classification system is effective in distinguishing neoplastic from non-neoplastic colorectal laterally spreading tumors.Further,it is effective to identify the lesions with deeper submucosal invasion.

关 键 词：蓝光成像 侧向发育型肿物 NICE分型 

分 类 号：R574.6[医药卫生—消化系统]