内镜窄带成像技术在结肠肿瘤诊断中的价值

目的 将内镜窄带成像技术（NBI）、色素内镜检查结果与病理学检查结果进行对比，探讨NBI在结肠肿瘤诊断中的价值。方法78例患者96个结肠病变进行NBI放大观察并与染色放大内镜观察和最终病理结果进行比较。结果普通肠镜发现息肉的敏感性为78．7％，切换NBI后，能清楚显示息肉性病变的形态和边界，发现息肉的敏感性99％。放大NBI肠镜对于Ⅱ型，Ⅲ1型，Ⅳ型，ⅤN型息肉腺管开口的图像与色素内镜图像有较好的相似性，NBI对于腺管开口的识别能力明显优于普通结肠镜，但是次于色素内镜。NBI对息肉表面血管形态进行分类对判断结肠是否有肿瘤的能力，其敏感性为100％，特异性为87．8％，同样明显优于普通结肠镜，而次于色素内镜。结论NBI肠镜及色素内镜均能提高发现结肠息肉的特异性、敏感性。色素内镜能清晰显示病变表面结构和腺管开口，使内镜下对于肿瘤与非肿瘤的鉴别诊断接近病理诊断。NBI放大肠镜能清晰显示息肉表面的毛细血管形态，较好地区分肿瘤与非肿瘤。NBI内镜切换简单快捷，便于全结肠观察，利于发现早期结肠肿瘤。

Narrow-Band Imaging in diagnosis of colorectal neoplasm

Objective To evaluate the efficacy of narrow-band imaging (NBI) in diagnosis of color-ectal neoplasm. Methods A total of 96 colorectal neoplasm from 78 patients were observed under NBI, and the findings were compared with those from magnifying chromo-endoscopy and pathologic examinations. Re-suits The sensitivity of conventional colonoscopy in diagnosis of polyps was 78. 7%, which was increased to 99% (P < 0. 05) under NBI, with the clear identification of the shape and boundary of the lesions. Magnif-ying NBI colonoscopy provided images of pit patterns similar to those from chromo-endoscopy in diagnosis of type Ⅱ , ⅢL, Ⅳ and ⅤN, which showed better recognition than conventional colonoscopy, but less sensitiv-ity than chromo-endoscopy. Superficial vascular morphologic features could be better classified with NBI, with sensitivity of 100% and specificity at 87. 8%, which was superior to conventional colonoscopy but infe-rior to chromo-endoscopy. Conclusion Both chromo-endoscopy and NBI colonoscopy have better sensitivity and specificity in detection of colon polyps, while chromo-endoscopy reveals clear superficial structure of le-sion and pit pattern, and NBI demenstrates capillary morphology, which can distinguish neoplasm from non-neoplasm colorectal lesions. NBI, easy and convenient to switch, is an effective technique to make early di-agnosis of colorectal neoplasm.