pit分型联合jnet分型在结直肠息肉病理分类诊断中的应用价值  

Analysis of application value of pit typing combined with jnet typing in pathological classification of colorectal polyps

作　　者：齐军 方新鑫 韩怡 QI Jun;FANG Xin-xin;HAN Yi(Department of Gastroenterology,Fuyang Hospital of Anhui Medical University,Fuyang 236000,Anhui,China)

机构地区：[1]安徽医科大学附属阜阳医院消化内科,安徽阜阳236000

出　　处：《川北医学院学报》2024年第6期771-774,共4页Journal of North Sichuan Medical College

基　　金：安徽省教育厅科研项目(KJ2020A0190;KJ2021A0339)。

摘　　要：目的:探究pit分型联合jnet分型在结直肠息肉病理分类判断中的应用价值。方法:选取102例结直肠息肉患者(共134个病灶)为研究对象,所有患者均接受内镜及病理检查。以病理诊断结果为金标准,比较pit分型、jnet分型对各病理分类结直肠息肉的诊断符合率。采用Kappa检验分析pit分型、jnet分型单独及联合诊断结直肠息肉性质的结果与病理诊断结果的一致性。结果:pit分型II型与病理诊断为非肿瘤性息肉的符合率为88.00%(22/25);IIIL型与病理诊断为管状腺瘤的符合率为91.38%(53/58);Ⅳ型与病理诊断为绒毛状腺瘤的符合率为80.00%(16/20);Ⅵ型与病理诊断为高级别上皮内瘤变(HGIN)/粘膜下浅层浸润癌(SM-s)的符合率为85.19%(23/27);VN型与病理诊断粘膜下深层浸润癌(SM-d)的符合率为50.00%(2/4)。jnet分型1型与病理诊断为非肿瘤性息肉的符合率为80.00%(20/25);2A型与病理诊断为腺瘤性息肉的符合率为84.62%(66/78);2B型与病理诊断为HGIN/SM-s的符合率为92.59%(25/27);3型与病理诊断为SM-d的符合率为100.00%(4/4)。pit分型、jnet分型及pit分型联合jnet分型诊断肿瘤性结直肠息肉的Kappa值分别为0.809、0.714、0.925。pit分型、jnet分型单独及联合诊断结直肠息肉的敏感度分别为88.00%、80.00%、92.00%,特异度分别为95.41%、93.58%、99.08%,阳性预测值分别为81.46%、74.07%、95.83%,阴性预测值分别为97.20%、95.33%、98.18%,准确度分别为94.03%、91.04%、97.76%。结论:pit分型联合jnet分型在结直肠息肉病理分类诊断中,可提高诊断结直肠息肉性质的准确性,为临床治疗决策提供指导。Objective:To explore the application value of pit typing combined with jnet typing in the pathological classification of colorectal polyps.Methods:A total of 102 patients with colorectal polyps(134 lesions)were selected as the research subjects.All patients underwent endoscopy and pathological examination.Pathological diagnosis results were used as the gold standard to compare the diagnostic coincidence rate of colorectal polyps in each pathological classification by pit typing and jnet typing.Kappa test was used to analyze the consistency between the pit typing,jnet typing and pathological diagnosis results.Results:The coincidence rate of pit type II and pathological diagnosis of non-neoplastic polyps was 88.00%(22/25).The coincidence rate of type IIIL and pathological diagnosis of tubular adenoma was 91.38%(53/58).The coincidence rate of type IV and pathological diagnosis of villous adenoma was 80.00%(16/20).The coincidence rate between type VI and pathological diagnosis of high-grade intraepithelial neoplasia(HGIN)/superficial submucosal invasive carcinoma(SM-s)was 85.19%(23/27).The coincidence rate of VN type and pathological diagnosis of submucosal deep invasive carcinoma(SM-d)was 50.00%(2/4).The coincidence rate of jnet type 1 and pathological diagnosis of non-neoplastic polyps was 80.00%(20/25).The coincidence rate of type 2A and pathological diagnosis of adenomatous polyps was 84.62%(66/78).The coincidence rate between type 2B and pathological diagnosis of HGIN/SM-s was 92.59%(25/27).The coincidence rate of type 3 and pathological diagnosis of SM-d was 100.00%(4/4).The Kappa values of pit typing,jnet typing and pit typing combined with jnet typing were 0.809,0.714 and 0.925,respectively.The sensitivity of pit typing and jnet typing alone and in combination were 88.00%,80.00%and 92.00%,the specificity were 95.41%,93.58%and 99.08%,the positive predictive value were 81.46%,74.07%and 95.83%,the negative predictive values were 97.20%,95.33%and 98.18%,the accuracy were 94.03%,91.04%and 97.76%,respectively.Concl

关 键 词：pit分型 jnet分型 结直肠息肉 病理分类 应用价值 

分 类 号：R735.3[医药卫生—肿瘤]