智能染色内镜诊断结肠病变腺管开口的临床价值及Ang-2表达、MVD值与腺管开口相关性研究

目的探讨FICE放大内镜对结肠瘤性、非瘤性病变的诊断价值以及血管生成素-2（Ang-2）表达、肿瘤微血管密度（MVD）与腺管开口的相互关系。方法选择富士能智能染色内镜（FICE）放大观查判定腺管开口为Ⅰ～Ⅴ型的结肠病变标本（Ⅰ～Ⅴ型各20例），Ⅰ、Ⅱ型纳入A组，Ⅲ、Ⅳ型纳入B组，Ⅴ型纳入C组。对照病理诊断结果，判断FICE放大内镜对结肠病变的诊断价值。并采用免疫组化SP法分别测定不同腺管开口结肠病变中Ang-2表达情况及MVD值，分析3者间的相互关系。结果FICE放大内镜对非瘤性病变诊断的敏感性和特异性分别为88．0％和92．5％，符合率为90．2％；对瘤性病变诊断的敏感性和特异性分别为94．8％和91．7％，符合率为93．2％；对结肠病变诊断的总符合率为92．0％。结肠病变中Ang-2的阳性表达率和MVD值在A组（Ⅰ、Ⅱ型合并组）、B组（Ⅲ、Ⅳ型合并组）、C组（腺管开口V型）3组逐渐升高。且Ang-2阳性表达组MVD值明显增高。结论FICE放大内镜对结肠病变腺管开口分型的判断可基本准确区别瘤性、非瘤性病变，结肠病变中Ang-2的阳性表达、肿瘤血管的生成与其腺管开口关系密切。

Observation of pit pattern in colorectal lesions with Fuji intelligent chromo endoscopy and its relationship with expression of Angiopoietin-2 and microvessel density

Objective To evaluate magnifying Fuji intelligent chromo endoscopy (FICE) in diagnosis of colorectal lesions,and to explore the correlation between pit pattern,expression of Angiopeietin-2 (Ang-2) and mierovessel density (MVD). Methods A total of 100 colorectal lesions with pit patterns ranging from type Ⅰ to type Ⅴ (20 cases in each type) determined by magnifying FICE were divided into group A (n = 40,type Ⅰ and Ⅲ ),group B (n = 40,type Ⅲ and Ⅳ ) and group C ( n = 20,type Ⅴ ). The resuits of FICE were compared with pathological findings. Expression of Ang-2 was examined by immunohistochemical streptavidin-perosidase method and MVD was calculated. The correlation between pit pattern,Ang2 expression and MVD was analyzed. Results The diagnostic sensitivity,specificity and consistent rates of magnifying FICE for non-neoplastic colorectal lesions were 88.0%,92. 5% and 90. 2%,respectively,and those for neoplastic lesions were 94. 8%,91.7% and 93. 2%,respectively,with an overall consistent rate for colorectal lesions at 92. 0%. The positive expression rate of Ang-2 and MVD were progressively increasing from group A,B to C. Conclusion Magnifying endoscopy with FICE is valuable to differentiate neoplastic colorectal lesions from non-neoplastic ones. The positive expression of Ang-2 and MVD are closely correlated with the pit patterns of colorectal lesions.