窄带成像结肠镜对结肠息肉样病变的诊断价值

探讨窄带成像（NBI）结肠镜对结肠息肉样病变的病理组织类型的预测能力.方法 125例患者接受结肠镜检查诊断结肠息肉样病变173个,根据腺管开口形态及NBI下血管分型判定该病变为肿瘤性病变（结肠腺瘤、结肠癌）或非肿瘤性病变,并与病理结果对照,判定各种方法的敏感性、特异性及准确率.结果 NBI下血管形态鉴别肿瘤性或非肿瘤性病变的敏感性、特异性及准确率（94.83%、91.23%、93.64%）以及隐窝形态结合血管形态鉴别肿瘤性或非肿瘤性病变的敏感性、特异性及准确率（95.69%、96.49%、95.59%）显著高于常规内镜（80.17%、84.21%、81.50%）（P〈0.05）.血管形态鉴别腺瘤与结肠癌的敏感性、特异性、准确率为86.90%、100.00%、87.93%.结论 NBI模式下结肠镜检查对息肉样病变的肿瘤性、非肿瘤性,结肠腺瘤、结肠癌的鉴别优于常规内镜检查,接近病理学检查.

Colonoscopy with narrow band imaging in diagnosis of colorectal polypoid lesions

Objective To investigate the value of colonoscopy with narrow band imaging (NBI) in predicting the histology of colorectal polypoid lesions. Methods A total of 173 colorectal polypoid lesions from 125 patients were included in the study. The lesions were diagnosed as neoplastic (adenoma or cancer)or non-neoplastic based on pit patterns and/or capillary patterns (CP), which was compared with the results of pathology, and the sensitivity, specificity and accuracy of each method were evaluated. Results In differentiation between neoplastic and non-neoplastic lesions, the sensitivity, specificity and accuracy of CP (94. 83% , 91. 23% and 93.64% , respectively), and those of CP combined with pit patterns (95. 69% ,96.49% and 95. 59% , respectively) were significantly higher than those of conventional colonoscopy (80. 17% , 84.21% and 81.50% , respectively, P<0.05). In differentiation between adenoma and cancer,the sensitivity, specificity and accuracy of CP were 86.90% , 100.00% and 87.93% , respectively.Conclusion NBI is superior to conventional colonoscopy in differentiation between neoplastic and non-neoplastic lesions, as well as in differentiation between adenoma and carcinoma.