内窥镜窄带成像技术观察结肠息肉癌变特征及其与RhoC蛋白表达相关性  

Observation of the cancerization feature of colon polyps by endoscope NBI and the correlation between that and the RhoC protein expression

作　　者：杨彬 王丽华 田志颖 赵彩红 张晓娟 YANG Bin;WANG Li-hua;TIAN Zhi-ying(Department of Gastroenterology,Hengshui People's Hospital,Hengshui 053000,China)

机构地区：[1]衡水市人民医院消化内科,河北衡水053000 [2]衡水市人民医院病理科,河北衡水053000

出　　处：《中国医学装备》2021年第11期93-96,共4页China Medical Equipment

基　　金：河北省卫健委2019年医学科学研究课题(20191759)“窄带技术观察结肠息肉癌变特征及RhoC蛋白表达相关性”。

摘　　要：目的:分析内窥镜窄带成像(NBI)技术观察结肠息肉癌变的特征及其与RhoC蛋白表达的相关性。方法:选取在医院消化内镜室就诊并接受结肠镜检查的200例结直肠息肉及癌变病灶患者(142个结直肠息肉及100个癌变病灶),依据诊断结果将其分为息肉组和恶变组,每组100例。息肉组中非腺瘤性息肉和腺瘤性息肉患者各50例;恶变组中高级别瘤变和癌变患者各50例。使用NBI结合放大肠镜观察病灶的微血管结构及表面结构,依据日本内镜NBI专家组(JNET)分型预测病变性质,对比分析内窥镜NBI诊断与病理结果的效能,分析NBI微血管形态特征与RhoC蛋白表达的相关性。结果:息肉组患者的RhoC蛋白表达呈现阳性的概率显著低于恶变组,差异有统计学意义(x^(2)=34.081,P<0.05)。恶变组中50例结肠息肉癌变患者黏膜及黏膜下浅层浸润RhoC表达阳性率低于黏膜下深层浸润,其差异有统计学意义(x^(2)=5.059,P<0.05)。JNET分型中2B型诊断结直肠黏膜下浅层浸润的灵敏度,特异度,准确度分别为76.9%、83.8%和82.1%;3型诊断结直肠黏膜下层浸润的灵敏度,特异度,准确度分别为73.1%、96.9%和94.8%。2B型诊治精确度为82.1%,低于3型(94.8%)。JNET分型中有癌变特征的2B型及3型病变与RhoC蛋白表达有相关性(r=0.453,P<0.05)。结论:内窥镜NBI技术结合放大肠镜下JNET分型对结直肠病变有很好的鉴别诊断价值,RhoC蛋白在结肠癌中高表达,且与结肠癌的发生、病变浸润深度密切相关,随着结直肠腺瘤的进展,病变部位RhoC蛋白表达逐渐增加。Objective:To analyze the cancerization feature of colon polyps in the observation with endoscope narrow band imaging(NBI)technique and the correlation of that and RhoC protein expression.Methods:A total of 200 patients(142 colorectum polyps and 100 cancerous lesions)with colorectum polyps and cancerous lesions who admitted to digestion and endoscope department and received colonoscopy were selected.They were divided into polyps group and malignant transformation group,with 100 cases in each group.In polyp group,there were 50 cases with non-adenomatous polyps and 50 cases with adenomatous polyps,respectively.In malignant transformation group,there were 50 cases with high-grade cancerization and 50 cases with cancerization.NBI combined with magnifying colonoscopy was used to observe the micro vascular structure and surface structure of lesions.According to Japan Narrow band imaging Expert Team(JNET)to classify and predict the nature of lesions.And the efficiencies of endoscopy NBI diagnoses and pathologic results were compared and analyzed,and the correlation between the morphological characteristics of NBI microvascular and RhoC protein expression was further analyzed.Results:The probability of positive RhoC protein expression of polyp group was significantly lower than that of malignant transformation group,and the difference of that between them was statistically significant(x2=34.081,P<0.05).In 50 cases with cancerization of colon polyps of malignant transformation group,the positive rate of RhoC protein expression in the infiltration of mucosal and submucosal superficial layer was significantly lower than that of the infiltration of submucosal deep layer,and the difference of that between them was significant(x2=5.059,P<0.05).In JNET classification,the sensitivity,specificity and accuracy of type 2B were 76.9%,83.8%and 82.1%in diagnosing the infiltration of submucosal superficial layer of colon and rectum,and those of type 3 were 73.1%,96.9%and 94.8%in diagnosing that.The accuracy of diagnosis and treatment of

关 键 词：结肠镜 窄带成像(NBI) 结肠息肉癌变 RhoC蛋白表达 相关性 

分 类 号：R735.35[医药卫生—肿瘤]