联动成像结合化学染色技术在大肠侧向发育型肿瘤分型中的应用价值  

Application of Linked Color Imaging Combined with Chemical Staining Technique in the Classification of Laterally Spreading Tumor of Large Intestine

作　　者：秦士钊 潘晓莉 尹跃霏 陈赛龄 杨文翠 QIN Shizhao;PAN Xiaoli;YIN Yuefei(Department of Gastroenterology,Xi'an International Medical Center Hospital,Xi'an Shaanxi 710100)

机构地区：[1]西安国际医学中心医院消化内科,陕西西安710100 [2]西安国际医学中心医院放射治疗中心,陕西西安710100

出　　处：《医学临床研究》2024年第1期47-50,共4页Journal of Clinical Research

摘　　要：【目的】探讨联动成像(LCI)结合化学染色技术在大肠侧向发育型肿瘤(LST)分型中的应用价值。【方法】回顾性分析在本院行LCI结合化学染色技术诊断的82例结直肠肿瘤患者(89处病变)的检查图像,对患者病灶表面的小凹形态进行判断,并依据黏膜表面细微腺管开口(Pit)形态分型预测病变性质。对比分析Pit分型与内镜下切除术后病理结果。【结果】Ⅰ、Ⅱ和Ⅱ-0型诊断多为锯齿状病变(SSP)/增生性息肉(HP)的灵敏度、特异度及准确度分别为55.56%、96.25%、92.13%;ⅢS型单独诊断黏膜下浸润癌浸润深度≥100 mm(SMd)的灵敏度、特异度及准确度分别为20.00%、98.81%、94.38%;Ⅲ_(L)和Ⅳ型诊断低度异型增生(LGD)/高度异型增生(HGD)的灵敏度、特异度及准确度分别为92.31%、83.33%、89.89%;Ⅴ_(n)型单独诊断SMd的灵敏度、特异度及准确度分别为40.00%、97.62%、94.38%;Ⅴ_(i)和Ⅴ_(n)型诊断黏膜内癌或黏膜下浸润癌但浸润深度<100 mm(m-SMs)/SMd的灵敏度、特异度及准确度分别为86.67%、97.30%、95.51%;Ⅲ_(S)型和Ⅴ_(n)型诊断SMd的灵敏度、特异度及准确度分别为60.00%、96.43%、94.38%。【结论】LCI结合化学染色术能够对结直肠肿瘤的Pit形态准确完整展现,更易判断肿瘤的病变性质是否为恶性,并可对肿瘤的浸润深度进行预判,其与病理诊断结果的符合率较高。【Objective】To explore the application of linked color imaging(LCI)combined with chemical staining technology in the classification of laterally spreading tumor of colorectal tumors(LST).【Methods】The examination images of 82 patients with colorectal tumors(89 lesions)diagnosed by LCI combined with chemical staining technology in our hospital were retrospectively analyzed,and the morphology of small pits on the surface of the lesions of the patients was evaluated.The characteristics of the lesions was predicted according to the morphological classification of small glandular canal opening(Pit)on the mucosal surface,And the Pit classification was compared with the pathologic results after endoscopic resection.【Results】The diagnosis of typeⅠ,ⅡandⅡ-0 were mostly serrated lesions(SSP)/hyperplastic polyps(HP).The sensitivity,specificity and accuracy were 55.56%,96.25%and 92.13%,respectively.The sensitivity,specificity and accuracy of typeⅢS alone in the diagnosis of submucosal invasive carcinoma with an invasion depth≥100 mm(SMd)were 20.00%,98.81%,and 94.38%,respectively.The sensitivity,specificity and accuracy of the diagnosis of low-grade dysplasia(LGD)/high-grade dysplasia(HGD)for typesⅢ_(L)and Ⅳ were 92.31%,83.33%,and 89.89%,respectively.The sensitivity,specificity and accuracy of typeⅤ_(n)alone in the diagnosis of SMd were 40.00%,97.62%,and 94.38%,respectively.The sensitivity,specificity and accuracy of typeⅤ_(i)andⅤ_(n)in the diagnosis of intramucosal carcinoma or submucosal invasive carcinoma with an invasion depth of less than 100 mm(m-SMs)/SMd were 86.67%,97.30%,and 95.51%,respectively.The sensitivity,specificity and accuracy of typeⅢ_(S)and typeⅤ_(n) in the diagnosis of SMd were 60.00%,96.43%,and 94.38%,respectively.【Conclusion】LCI combined with chemical staining can accurately and completely display the Pit shape of rectal mass,which makes it easier to assess whether the mass is neoplasm.And the predicted depth of tumor invasion of the has a high coincidence rate with t

关 键 词：结直肠肿瘤/诊断 结肠镜检查 免疫组织化学 

分 类 号：R735.35[医药卫生—肿瘤]