应用染色放大内镜进行JNET分型与Pitpattern分型在结直肠侧向发育型肿瘤中的诊断价值分析  

Analysis of the diagnostic value of JNET and Pit pattern classifications using chromoendoscopy with magnification in laterally spreading tumors of the colorectum

作　　者：黄波 赵丽然[1] 张晓旭 张玲[1] 涂征艳[1] 王春晖 高天霞[1] HUANG Bo;ZHAO Li-ran;ZHANG Xiao-xu(Department of Gastroenterology,Daqing Longnan Hospital,Daqing 163458,China)

机构地区：[1]大庆龙南医院消化内科,163458

出　　处：《中国实用医药》2025年第7期19-23,共5页China Practical Medicine

基　　金：黑龙江省卫生健康委科研课题(项目编号20220303030962),项目名称:应用染色放大内镜对结直肠侧向发育型肿瘤(LST/SSL)进行JNET、Pattern诊断与病理诊断的实践。

摘　　要：目的应用染色放大内镜对结直肠侧向发育型肿瘤(LST)患者进行日本内镜窄带光成像(NBI)技术专家小组(JNET)分型、Pit pattern分型,探究其诊断价值和临床意义。方法108例疑似结直肠LST并接受内镜黏膜下剥离术(ESD)患者,通过术前应用染色放大内镜进行JNET、Pit pattern分型,并与ESD术后病理结果进行一致性分析,对比JNET分型及Pit pattern分型对结直肠LST的诊断效能。结果108例患者最终术后病理分型为非肿瘤性病变25例,肿瘤性病变83例。Pitpattern分型诊断结果与病理诊断结果有一定的一致性,差异具有显著统计学意义(Kappa值=0.519,P<0.001)。JNET分型诊断结果与病理诊断结果有一定的一致性,差异具有显著统计学意义(Kappa值=0.452,P<0.001)。JNET分型及Pit pattern分型诊断结直肠LST的特异度、阳性预测值、阴性预测值对比无显著差异(P>0.05)。JNET分型诊断结直肠LST的敏感度98.8%、准确率88.9%明显高于Pit pattern分型的91.6%、78.7%,差异具有统计学意义(P<0.05)。结论应用染色放大内镜进行JNET分型与Pit pattern分型对结直肠LST诊断具有良好价值,JNET分型优于Pitpattern分型。Objective To explore the diagnostic value and clinical significance of Japan Narrow-Band Imaging(NBI)Expert Team(JNET)and Pit pattern classifications for patients with laterally spreading tumor(LST)of the colorectum using chromoendoscopy with magnification.Methods 108 patients with suspected colorectal LST who undergoing endoscopic submucosal dissection(ESD)were included.Preoperative JNET and Pit pattern classifications of colorectal LST were performed using chromoendoscopy with magnification,and these classifications were compared with postoperative pathological results from ESD to analyze the diagnostic efficacy of JNET and Pit pattern classifications for colorectal LST.Results The final postoperative pathological classification of 108 patients was non-neoplastic lesions in 25 cases and neoplastic lesions in 83 cases.There was a certain consistency between Pit pattern classification and pathological diagnosis,and the difference was statistically significant(Kappa value=0.519,P<0.001).There was certain consistency between JNET classification and pathological diagnosis,and the difference was statistically significant(Kappa value=0.452,P<0.001).There were no significant differences in the specificity,positive predictive value and negative predictive value for colorectal LST between JNET and Pit pattern classifications(P>0.05).The sensitivity and accuracy of JNET classification in the diagnosis of colorectal LST were 98.8%and 88.9%,which were significantly higher than 91.6%and 78.7%of Pit pattern classification,and the difference was statistically significant(P<0.05).Conclusion Chromoendoscopy with magnification for JNET and Pit pattern classifications has good diagnostic value for colorectal LST,with JNET classification being superior to Pit pattern classification.

关 键 词：染色放大内镜 侧向发育型肿瘤 日本内镜窄带光成像技术专家小组分型 Pit pattern分型 诊断价值 

分 类 号：R735.3[医药卫生—肿瘤]