窄带成像放大内镜检查对结肠癌癌前病变的诊断价值  

Diagnostic value of narrow band imaging-magnifying endoscopy for precancerous lesions of colon cancer

作　　者：方圆 卢艳萍 赵虬凤 FANG Yuan;LU Yanping;ZHAO Qiufeng(Department of Gastroenterology,Lishan Campus,Anshan Central Hospital,Anshan 114000,Liaoning,China)

机构地区：[1]鞍山市中心医院立山院区消化内科,辽宁鞍山114000

出　　处：《癌症进展》2024年第4期435-437,441,共4页Oncology Progress

摘　　要：目的探讨窄带成像放大内镜(NBI-ME)检查对结肠癌癌前病变的诊断价值。方法选取106例疑似结肠癌癌前病变患者,均接受NBI-ME、白光内镜检查,以手术病理检查结果为金标准,评估NBI-ME、白光内镜检查对结肠癌癌前病变的诊断价值。NBI-ME、白光内镜检查诊断结肠癌癌前病变的结果与病理检查结果的一致性采用Kappa检验。比较NBI-ME、白光内镜检查的图像清晰度。结果病理检查结果显示,阳性(结肠癌癌前病变)92例,阴性14例(其中结肠腺瘤2例,结肠息肉12例)。NBI-ME检查诊断结肠癌癌前病变的灵敏度为96.74%,特异度为92.86%,准确度为96.23%,其与病理检查结果的一致性较好(Kappa=0.772);白光内镜检查诊断结肠癌癌前病变的灵敏度为78.26%,特异度为50.00%,准确度为74.53%,其与病理检查结果的一致性一般(Kappa=0.596);NBI-ME检查诊断结肠癌癌前病变的灵敏度、特异度、准确度均高于白光内镜检查。NBI-ME检查的图像清晰度评分为(3.67±0.22)分,明显高于白光内镜检查的(2.97±0.41)分,差异有统计学意义(P﹤0.01)。结论NBI-ME检查诊断结肠癌癌前病变的价值较高,诊断灵敏度、特异度、准确度均高于白光内镜检查。Objective To analyze the diagnostic value of narrow band imaging-magnifying endoscopy(NBI-ME)for precancerous lesions of colon cancer.Method A total of 106 patients with suspected precancerous lesions of colon cancer were selected,all patients underwent NBI-ME and white light endoscopy examinations.The surgical pathological examination results as the gold standard,the diagnostic value of NBI-ME and white light endoscopy examinations for precancerous lesions of colon cancer were evaluated.The consistency between the results of NBI-ME and white light endoscopy in diagnosing precancerous lesions of colon cancer and the pathological examination results was tested by Kappa.The image clarity of NBI-ME and white light endoscopy examinations were compared.Result The pathological examination results showed that 92 cases were positive(precancerous lesions of colon cancer)and 14 cases were negative(2 cases of colorectal adenomas,12 cases of colon polyps).The sensitivity,specificity,and accuracy of NBI-ME examination in diagnosing precancerous lesions of colon cancer were 96.74%,92.86%,and 96.23%,respectively,the Kappa test showed a good consistency between NBI-ME and gold standard(Kappa=0.772).The sensitivity,specificity,and accuracy of white light endoscopy in diagnosing precancerous lesions of colon cancer were 78.26%,50.00%,and 74.53%,respectively,the Kappa test showed general agreement consistency between white light endoscope examination and gold standard(Kappa=0.596).The sensitivity,specificity,and accuracy of NBI-ME examination in diagnosing precancerous lesions of colon cancer were higher than those of white light endoscopy examination.The image clarity score of NBI-ME examination was(3.67±0.22)points,significantly higher than(2.97±0.41)points of white light endoscopy examination,and the difference was statistically significant(P<0.01).Conclusion NBI-ME examination has a high value in diagnosing precancerous lesions of colon cancer,with higher diagnostic sensitivity,specificity,and accuracy than white light endosc

关 键 词：结肠癌癌前病变 窄带成像放大内镜 白光内镜 诊断效能 

分 类 号：R735.35[医药卫生—肿瘤]