超声内镜联合窄带成像-放大内镜下JNET分型评估结直肠肿瘤性病变浸润深度的价值分析  

Value Analysis of JNET Typing under Endoscopic Ultrasonography Combined with Narrow Band Imaging and Magnifying Endoscopy in Evaluating Infiltration Depth of Colorectal Neoplastic Lesions

作　　者：张静文 李阳[1] 亚冰玉 ZHANG Jing-wen;LI Yang;YA Bing-yu(Department of Endoscopy,Nanyang Second People's Hospital,Nanyang,Henan 473000)

机构地区：[1]南阳市第二人民医院内镜诊疗科,河南南阳473000

出　　处：《中国肛肠病杂志》2023年第11期7-10,共4页Chinese Journal of Coloproctology

摘　　要：目的:探讨超声内镜(EUS)联合窄带成像-放大内镜(NBI-ME)下JNET分型评估结直肠肿瘤性病变浸润深度的价值。方法:选择2020年1月至2023年1月我院收治的61例结直肠息肉样病变患者作为研究对象,患者术前均通过EUS检查评估黏膜浸润深度,均于NBI-ME下观察病变部位微血管微腺管进行JNET分型,并于内镜下进行手术治疗,手术标本组织送病理检查。以病理检查结果为标准,分析EUS、JNET分型单项及EUS+JNET分型联合判定肿瘤病变浸润深度的价值。结果:本组61例患者肿瘤性病灶70处。EUS、JNET分型联合评估结直肠肿瘤性病变浸润深度的敏感度为100.0%,特异性为90.91%,阳性预测值为93.33%,阴性预测值为100.0%。EUS、JNET分型单项与两项联合评估结直肠肿瘤性病变浸润深度与病理检查相比,Kappa值分别为0.598、0.582和0.842。结论:EUS联合NBI-ME下JNET分型评估结直肠肿瘤性病变浸润深度效果优于EUS及JNET分型单项评估,临床应用价值更大。Objective To analyze the value of JNET typing under endoscopic ultrasonography(EUS)combined with narrow band imaging and magnifying endoscopy(NBI-ME)in evaluating the infiltration depth of colorectal neoplastic lesions.Methods Total 61 patients with colorectal polypoid lesions admitted to our hospital from January 2020 to January 2023 were selected as the study objects.The depth of mucosal infiltration was evaluated by EUS before surgery,microvessels and microglandular ducts at the lesion site were observed under NBI-ME for JNET typing,and surgical treatment was performed under endoscope.The surgical specimens were sent for the pathological examination.The value of EUS,JNET classification and EUS+JNET classification in determining the infiltration depth of neoplastic lesions was analyzed based on the pathological examination results.Results There were 70 neoplastic lesions in 61 patients.The sensitivity,specificity,positive predictive value,and negative predictive value were 100.0%,90.91%,93.33%,and 100.0%,respectively.Compared with the pathological examination,Kappa values in the infiltration depth of colorectal neoplastic lesions assessed by EUS,JNET classification and EUS+JNET classification were 0.598,0.582 and 0.842,respectively.Conclusion JNET classification under EUS combined with NBI-ME is more effective than EUS and JNET classification in evaluating the infiltration depth of colorectal neoplastic lesions,and has greater clinical application value.

关 键 词：结直肠肿瘤性病变 浸润深度 超声内镜 窄带成像-放大内镜 JNET分型 评估 

分 类 号：R735.34[医药卫生—肿瘤]