联动成像模式和亮蓝光成像模式在大肠侧向发育型肿瘤中的临床应用价值  

Clinical application of linked color imaging and blue light imaging-bright in laterally spreading tumor

作　　者：林吟 邹东东 黄兆许 吴以龙 LIN Yin;ZOU Dongdong;HUANG Zhaoxu;WU Yilong(Department of Gastroenterology,Fuding Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuding 355200,China;不详)

机构地区：[1]福建中医药大学附属福鼎医院消化内科,福建福鼎355200 [2]福建中医药大学附属福鼎医院肛肠科,福建福鼎355200

出　　处：《实用医学杂志》2023年第4期487-492,共6页The Journal of Practical Medicine

摘　　要：目的 评估蓝激光内镜系统不同模式在大肠侧向发育型肿瘤(laterally spreading tumor,LST中的临床应用价值。方法 回顾性分析2017年5月至2021年12月于福建中医药大学附属福鼎医院收治的接受蓝激光结肠镜亮蓝光成像模式(blue laser imaging-bright,BLI-bright)、联动成像模式(linked color imaging,LCI)和普通白光模式(white light imaging,WLI)进行详细检查的连续性LST患者,其中男45例、女31例,年龄45~86岁,中位年龄72岁。主观可视性分析由6名内镜医师完成,按年资分成高年资组和低年资组,每组各3名,主要观察指标为LST可视性评分(ranking score,RS)。客观色差分析主要比较3种模式下LST与周边黏膜的总色差(ΔE),色差采用国际照明委员会的1976 L*a*b*系统。结果 (1)WLI、BLI-bright和LCI模式下6名内镜医师的RS总体评分分别为(3.27±0.48)分、(3.05±0.59)分和(3.42±0.30)分,LCI模式下RS总体评分明显高于BLI-bright模式(t=5.286,P <0.001)和WLI模式(t=2.647,P=0.010),而BLI-bright模式低于WLI模式(t=2.289,P=0.025)。亚组分析显示:高年资组3种模式之间的差异无统计学意义(F=1.126,P=0.326);低年资组LCI模式的RS评分为(3.32±0.41)分,明显高于BLI-bright模式的(2.64±0.85)分(t=6.194,P <0.001)和WLI模式的(3.01±0.69)分(t=3.715,P <0.001)。(2)WLI、BLI-bright和LCI模式下LST与周边黏膜的总色差(ΔE)分别为16.81±6.91、11.32±3.17和27.21±7.57,LCI模式下ΔE明显高于BLI-bright模式(t=30.934,P <0.001)和WLI模式(t=61.411,P <0.001),而BLI-bright模式低于WLI模式(t=12.404,P <0.001)。并且,LCI模式下亮度的差异(ΔL)、红绿色分量的色差(Δa)和黄蓝色分量的色差(Δb)均高于BLI-bright模式和WLI模式(均P <0.001),而BLI-bright模式均低于WLI模式(均P <0.05)。在WLI和LCI模式下色差主要由红绿色分量的色差(Δa)和黄蓝色分量的色差(Δb)产生,而在BLI-bright模式下色差主要由红绿色分量的色差(Δa)产生。结论 蓝激光内镜系统中的LObjective To investigate the clinical application of LASEREO endoscopic system in laterally spreading tumor(LST).Methods Patients who underwent blue laser imaging-bright(BLI-bright)mode,linked color imaging(LCI)mode and white light imaging(WLI)mode of LASEREO colonoscopy from May 2017 to December2021 at Fuding Hospital Affiliated to Fujian University of Traditional Chinese Medicine were retrospective analyzed.Among 76 patients,the male to female ratio was 45 to 31 with a median age of 72 years.Subjective visibility analysis was performed by 6 endoscopists and divided into 2 groups(experts and trainees groups)with 3 endoscopists for each group.The main observation index was the visibility score(ranking score,RS).The objective color difference(ΔE)between LST and surrounding mucosa in 3 modes were analyzed by using the L*a*b*color space.Results(1)The RS score of WLI,BLI-bright and LCI were(3.27 ± 0.48),(3.05 ± 0.59)and(3.42 ± 0.30),respectively.The RS score of LCI was significantly higher than BLI-bright(t = 5.286,P<0.001)and WLI(t = 2.647,P = 0.010),while BLI-bright was significantly lower than WLI(t = 2.289,P = 0.025).When we compared between experts and trainees groups,there was no significant difference in experts group(F = 1.126,P = 0.326);for trainees group,the RS score of LCI(3.32 ± 0.41)was significantly higher than BLI-bright(2.64 ± 0.85)(t = 6.19,P<0.001)and WLI(3.01 ± 0.69)(t = 3.715,P<0.001).(2)The color difference(ΔE)of WLI,BLI-bright and LCI were 16.8 ±6.91,11.32 ± 3.17,and 27.21 ± 7.57,respectively.The color difference(ΔE)of LCI was significantly higher than BLI-bright(t = 30.934,P<0.001)and WLI(t = 61.411,P<0.001),while BLI-bright was significantly lower than WLI(t = 12.404,P<0.001).Moreover,the difference in brightness(ΔL),red-green components(Δa)and yellow-blue components(Δb)of LCI were all significantly higher than BLI-bright and WLI(P<0.001),while BLIbright were all significantly lower than WLI(P<0.05).The color difference(ΔE)is mainly produced by red-green components(Δa)and yell

关 键 词：结肠肿瘤 大肠侧向发育型肿瘤 联动成像模式 亮蓝光成像模式 

分 类 号：R735.3[医药卫生—肿瘤]