窄带成像内镜下NICE分型对结直肠肿瘤的诊断价值

目的探讨采用非放大内镜的简化的窄带成像技术（NBI）内镜下分型系统（NICE分型）在内镜诊断结直肠肿瘤中的应用价值。方法对结肠镜检查发现的181处结直肠新生性病变进行NBI内镜检查，观察病变的颜色、微血管结构及表面结构，依据NICE分型标准预测病变性质，并与内镜下或外科手术切除后标本的病理结果进行对比分析。结果NBI内镜下NICE总体分型诊断结直肠肿瘤的总体敏感度、总体特异度、总体阳性预测值、总体阴性预测值和总体准确率分别为95．8％（114／119）、91．9％（57／62）、95．8％（114／119）、91．9％（57／62）和94．5％（171／181）；对微小息肉（≤0．5cm）、小息肉（〉0．5—0．9em）和大息肉（〉0．9Cm）诊断的准确率分别为90．0％（72／80）、95．9％（47／49）和98．1％（51／52），差异无统计学意义（P=0．175）；诊断直乙结肠微小肿瘤的敏感度、特异度、阳性预测值、阴性预测值和准确率分别为87．5％（14／16）、95．2％（20／21）、93．3％（14／15）、90．9％（20／22）和91．9％（34／37）。结论依据NICE分型标准使用高分辨率NBI能够较好区分结直肠肿瘤性和非肿瘤性病变，基本可以满足临床需要。

Efficacy of NICE classification under narrow-band imaging in real-time diagnosis of colorectal polyps

Objective To evaluate the diagnostic efficacy of non-magnified NBI in distinguishing neoplastic from non-neoplastic colorectal polyps, using a simple classification system（ NBI international colorectal endoscopic NICE ] classification）. Methods A total of 181 lesions detected by white light colonoscopy were enrolled in this prospective study. Each lesion was assessed by NBI, and the histology was predicted according to characteristics of lesion color, micr0vascular architecture, and surface pattern. The results were compared with actual histologic findings. Results The diagnostic sensitivity, specificity, PPV, NPV, and accuracy of NBI were 95.8% （114/119）, 91.9% （57/62）, 95.8% （114/119）, 91.9% （57/62）, and 94. 5% （ 171/181 ）, respectively. Diagnostic accuracy was 90. 0% （72/80） in the 1 to 5 mm group, 95.9% （47/49） in the 6 to 9 mm group, 98.1% （51/52） in the more than 10 mm group, with no statistically significant differenees（P =0. 175）. The sensitivity, specificity, PPV, NPV, and accuracy of NBI for diminutive reetosigmoid neoplasms were 87.5% （ 14/16）, 95.2% （20/21）, 93.3% （ 14/15）, 90. 9% （20/22）, and 91.9% （34/37）. Conclusion NICE classification with non-magnified NBI is effective in distinguishing neoplastic from non-neoplastic coloreetal lesions.