联动成像技术与白光内镜对预测缓解期溃疡性结肠炎组织学愈合的价值研究  

Comparison between Linked Colour Imaging and White Light Imaging in Predicting Histological Healing of Ulcerative Colitis

作　　者：覃燕萍 邓哲君 赵磊[3] 孟云超[1] 张海莲[1] 谭显清[4] 黄福全[4] 王媛媛[3] 张启芳[1] QIN Yanping;DENG Zhejun;ZHAO Lei;MENG Yunchao;ZHANG Hailian;TAN Xianqing;HUANG Fuquan;WANG Yuanyuan;ZHANG Qifang(Department of Gastroenterology,Nanxi Mountain Hospital,Guangxi Zhuang Autonomous Region,Guilin 541001,China;Department of Gastroenterology,Guangxi Zhuang Autonomous Region People′s Hospital,Nanning 530021,China;Department of Pathology,Nanxi Mountain Hospital,Guangxi Zhuang Autonomous Region,Guilin 541002,China;Endoscopy Center,Nanxishan Hospital,Guangxi Zhuang Autonomous Region,Guilin 541002,China)

机构地区：[1]广西壮族自治区南溪山医院消化内科,541001 [2]广西壮族自治区人民医院消化内科,530021 [3]广西壮族自治区南溪山医院病理科,541002 [4]广西壮族自治区南溪山医院内镜中心,541002

出　　处：《现代消化及介入诊疗》2024年第9期1048-1054,共7页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：广西医疗卫生重点培育学科建设项目,广西壮族自治区卫生健康委计划课题(z20191039)。

摘　　要：目的探讨联动成像技术(Linked Colour Imaging,LCI)与白光内镜(White Light Imaging,WLI)对预测缓解期溃疡性结肠炎(Ulcerative colitis,UC)患者黏膜组织学愈合的价值。方法使用WLI、LCI两种内镜检查技术对缓解期UC患者进行结肠黏膜进行观察,采集并保存内镜图像。首先,对采集的图像进行白光内镜评分(MES,Mayo Endoscopic Score)和LCI分级。随后,将LCI采集到的内镜图像导入Adobe Photoshop CS4软件,对图像的发红程度进行数字化分析,得到LCI指数,分析LCI指数与LCI分级、组织病理分级的相关性。然后,将MES、LCI分级分别与患者的组织病理分级进行相关性研究。计算LCI分级和MES与组织病理分级的Spearman相关系数。通过受试者工作特征(Receiver Operator Characteristic,ROC)曲线下面积(Area Under Curve,AUC)评价LCI分级与MES预测缓解期UC组织学愈合的能力。结果根据Spearman相关性分析显示,LCI指数与LCI分级具有显著相关性(r=0.644,P<0.001),LCI分级与组织学愈合之间具有显著相关性(r=0.719,P<0.001),而MES与组织学愈合之间不相关(r=0.125,P>0.05)。LCI分级判断组织学愈合的AUC为0.810,其灵敏度和特异度分别为70.5%和81.8%;MES判断组织学愈合的AUC为0.647(其灵敏度和特异度分别为68.8%和60.6%),两者比较的P值为0.038,差异具有统计学意义。结论LCI分级预测组织学愈合的能力高于MES。LCI技术可能是预测缓解期UC患者组织学愈合的一种有效的新方法。Objective The aim of this study is to investigate the predictive value of Linked Colour Imaging(LCI)and White Light Imaging(WLI)in the histological healing of UC mucosa.Methods Colonoscopy was performed on patients with UC in remission,and the colonic mucosa was observed by WLI and LCI,and endoscopic pictures were collected,and the images were classified by Mayo Endoscopic Score(MES)and LCI classification.First,the images collected from LCI were imported into Adobe Photoshop CS4 software,and the redness of the images was digitally analyzed as the LCI index.The correlation between LCI index and LCI grade and histopathological grade was analyzed.Then,the correlation between MES and LCI grades and histopathologic grades of patients was studied.The Spearman correlation coefficient of LCI grade and MES with histopathological grade was calculated.The ability of LCI grading and MES to diagnose histological healing of UC in remission was evaluated by Receiver Operator Characteristic(ROC)Area Under Curve(AUC).Results According to Spearman′s correlation analysis,There was a significant correlation between LCI index and LCI grade(r=0.644,P<0.001).There was a significant correlation between LCI classification and histological healing(r=0.719,P<0.001),while there was no correlation between MES and histological healing(r=0.125,P>0.05).The AUC of LCI classification for histological healing was 0.810,and its sensitivity and specificity were70.5%and 81.8%respectively.The AUC of MES for histological healing was 0.647(the sensitivity and specificity were 68.8%and 60.6%,respectively),and the P value between the two was 0.038,and the difference was statistically significant.Conclusion The ability of LCI grade to judge histological healing is higher than that of Mayo endoscopic score.LCI may become a new method for endoscopy,disease evaluation,and histopathology prediction in patients with ulcerative colitis.

关 键 词：溃疡性结肠炎 联动成像技术 白光内镜 组织学愈合 

分 类 号：R574[医药卫生—消化系统]