蓝激光成像技术联合微探头超声内镜预测早期结直肠癌浸润深度的诊断价值  

Diagnostic value of blue laser imaging combined with micro probe endoscopic ultrasonography in predicting invasion depth of early colorectal cancer

作　　者：莫波 杜超 乔丽娟 杨明 陈虹彬 徐辉 MO Bo;DU Chao;QIAO Lijuan;YANG Ming;CHEN Hongbin;XU Hui(Department of Gastroenterology,Chinese People's Liberation Army Western Hospital General Hospital,Chengdu 610083,China)

机构地区：[1]中国人民解放军西部战区总医院消化内科,四川成都610083

出　　处：《西部医学》2022年第8期1187-1192,共6页Medical Journal of West China

基　　金：国家自然科学基金青年项目(NSFC81702425)。

摘　　要：目的探讨蓝激光成像技术(BLI)联合微探头超声内镜(EUS)检查在预测早期结直肠肿瘤浸润深度的诊断价值。方法纳入2018年1月〜2020年12月我院经结肠镜及病理组织学检查明确诊断为早期结直肠癌(CRC)的患者289例,患者在接受内镜或外科手术治疗前完成BLI-ME和(或)EUS检查并判断其浸润深度,将纳入研究患者随机分为蓝激光成像技术组(BLI组),微探头超声内镜检查组(EUS组),蓝激光成像技术联合微探头超声内镜检查组(BLI+EUS组)。对比分析3组患者不同内镜模式下对早期结直肠癌浸润深度的敏感度、特异度及准确性;对不同内镜诊断结果与病理结果进行一致性比较,单因素分析一致组与非一致组,组间结果不一致的影响因素,对比分析BLI组与EUS组患者检查所用时间与患者主观感受(1~10分)。结果BLI+EUS组诊断准确率优于BLI组及EUS组(P<0.05)。BLI+EUS组与病理诊断的一致性(Kappa=0.761)相较于BLI组(Kappa=0.576)及EUS组一致性(Kappa=0.574)更好。将内镜检查结果与病理诊断结果一致组与非一致组进行单因素分析显示,年龄、病灶大小、大体形态、病变浸润深度四个方面的差异具有统计学意义(P<0.05)。BLI组所用时间明显缩短,且患者主观感受明显优于EUS组(P<0.05)。结论蓝激光成像技术联合微探头超声内镜在早期结直肠癌浸润深度预测方面具有更高的准确率,检查结果可靠,在早期结直肠癌的术前评估中具有良好的临床应用价值。Objective The purpose of this study was to explore the diagnostic value of blue laser imaging(BLI)combined with micro probe endoscopic ultrasonography(EUS)in predicting the depth of early colorectal tumor invasion.Methods This clinical study is a single-center,retrospective study from the General Hospital of the Western Theater Command of the Chinese People’s Liberation Army.289 patients with early colorectal cancer(CRC)diagnosed by colonoscopy and histopathological examination from January 2018 to December 2020 were included.The patients completed BLI-ME and/or EUS examination and judged the depth of invasion before receiving endoscopic or surgical treatment.Randomly divide the patients into three groups.Group A was treated with blue laser imaging technology,group B was treated with endoscopic ultrasonography,and group C was treated with blue laser imaging technology combined with endoscopic ultrasonography.Results the patients were divided into the two groups:mucosa to superficial submucosa(m-SMs,infiltration depth<1000μm)or deep submucosa(SMD,infiltration depth≥1000μm).The sensitivity,specificity and accuracy of three groups of patients with different endoscopic modes on the depth of invasion of early colorectal cancer were compared and analyzed.The consistency of different endoscopic diagnosis results and pathological results was compared.Univariate analysis of consistent group and non-consistent group,influencing factors of inconsistent results between groups,and the examination time and subjective feelings of patients in group A and group B were compared and analyzed(1-10 points).Results the diagnostic accuracy of blue laser imaging technology combined with micro probe EUS was better than that of blue laser imaging technology group and micro probe EUS group.The consistency of blue laser imaging combined with micro probe EUS and pathological diagnosis(kappa=0.761)was better than that of blue laser imaging group(kappa=0.576)and micro probe EUS group(kappa=0.574).Univariate analysis showed that there wer

关 键 词：蓝激光成像 超声内镜检查 早期结直肠肿瘤 浸润深度 一致性 

分 类 号：R735.37[医药卫生—肿瘤]