放大窄带成像内镜JNET分型在结直肠肿瘤中的临床应用  

Clinical application of JNET classification under magnifying endoscopy with narrow-band imaging in colorectal tumors

作　　者：邱全兴[1] 汤瑜[1] 胡学军[1] 袁保[1] QIU Quanxing;TANG Yu;HU Xuejun;YUAN Bao(Jiangyin Affliated Hospital of Nanjing University of Traditional Chinese Medicine,Jiangyin Hospital of Traditional Chinese Medicine,Wuxi 214400,China)

机构地区：[1]南京中医药大学附属江阴医院,江阴市中医院,江苏无锡214400

出　　处：《临床医药实践》2023年第12期896-899,共4页Proceeding of Clinical Medicine

摘　　要：目的:探讨放大窄带成像内镜日本窄带成像技术专家小组(JNET)分型在结直肠肿瘤诊断中的临床应用价值。方法:回顾性分析放大窄带成像内镜检查的106处结直肠肿瘤,并进行JNET分型,与内镜或外科手术标本病理诊断进行比较,评估JNET分型的准确性。结果:结肠肿瘤术后标本病理提示:非早癌病例70例,其中增生性息肉(包括锯齿状息肉)10例,低级别上皮内瘤变60例;早癌病例36例,其中高级别上皮内瘤变21例,黏膜下浅层癌7例,黏膜下深层癌8例。JNET各分型其准确性、特异性、敏感性、阳性预测值以及阴性预测值如下。1型:98.11%,98.96%,90.00%,90.00%,98.96%,2A型:80.19%,71.74%,86.67%,80.00%,80.49%;2B型:77.36%,84.62%,57.14%,57.14%,84.62%;3型:95.28%,100.00%,37.5%,100.00%,95.15%;JNET分型对结直肠病变早癌诊断的准确性、特异性、敏感性、阳性预测值及阴性预测值为:82.08%,90.00%,66.67%,77.42%,84.00%。结论:JNET分型能有效实时判断结直肠肿瘤性病变的良恶性程度,对部分诊断困难病变需结合放大染色内镜提高准确率。Objective:To evaluate the clinical value of Japan Narrow Band Imaging Expert Team(JNET)classification under magnifying endoscopy with narrow-band imaging for colorectal tumors.Methods:Data of 106 colorectal tumors detected by magnifying endoscopy with narrow-band imaging were reviewed in the retrospective study.JNET typing classification was used for rediagnosis.In order to evaluate the accuracy of JNET typing classification,the results were compared with histological results after endoscopic resection or surgery.Results:The pathological findings of postoperative specimens of colon tumors showed that there were 70 cases of non-early cancer,including 10 cases of hyperplastic polyps(including serrated polyps),60 cases of low-grade intraepithelial neoplasia,36 cases of early cancer,and 30 cases of malignant tumors,there were 21 cases of high grade intraepithelial neoplasia,7 cases of superficial submucosal carcinoma and 8 cases of deep submucosal carcinoma.The respective accuracy,specificity,sensitivity,positive predictive value,and negative predictive value were as follows.Type1:98.11%,98.96%,90.00%,90.00%,98.96%,Type 2A:80.19%,71.74%,86.67%,80.00%,80.49%;Type 2B:77.36%,84.62%,57.14%,57.14%,84.62%;Type 3:95.28%,100.00%,37.5%,100.00%,95.15%。The diagnostic accuracy,specificity,sensitivity,positive predictive value,and negative predictive value of JNET classification for colorectal early cancer lesions was 82.08%,90.00%,66.67%,77.42%,84.00%.Conclusion:JNET classification under NBI is effective in judging the colorectal tumor.For low confidence cases,Magnifying Chromoendoscopy is recommended to ensure correct diagnoses.

关 键 词：窄带成像内镜 日本窄带成像技术专家小组分型 结直肠肿瘤 

分 类 号：R574[医药卫生—消化系统]