内镜智能分光比色与染色技术对大肠肿瘤诊断价值的研究

目的 探讨内镜智能分光比色技术(FICE)与染色技术鉴别大肠肿瘤及非肿瘤性病变的价值.方法 选择2007年3月至2008年5月间245例入选病例,分别采用常规放大技术、FICE放大技术及染色放大技术对病变进行腺管开口分型及毛细血管形态观察,对病变做出诊断,并与病理组织学诊断相比较.结果 在245例患者中发现新生性病变480个,其中常规放大内镜下发现病变90.0%(432/480),FICE放大模式下发现病变98.8%(474/480),差异有统计学意义(P<0.01).FICE放大内镜比染色放大内镜更能清晰显示黏膜毛细血管结构形态(P<0.01),在显示腺管开口方面两者差异无统计学意义.FICE放大内镜对肿瘤性及非肿瘤性病变判断的符合率为92.2%(437/474),染色放大内镜符合率为81.0%(389/480),前者高于后者(P<0.01).结论 FICE放大内镜可以观察黏膜表面微细结构及毛细血管形态,比普通放大内镜及染色放大内镜对大肠肿瘤性及非肿瘤性病变鉴别诊断的符合率高,操作转换简便,可指导对病变进行靶向活检,有良好的临床实用价值.

Intelligent chromo endoscopy and endoscopic staining in diagnosis of colon neoplasm

Objective To evaluate the Fuji intelligent chromo endoscopy (FICE) and endoscopic staining in differential diagnosis between colon neoplasm and non-neoplasm. Methods A total of 480 protruding lesions in colon were detected in 245 patients, of which 90. 0% (432/480) could be detected by routine magnifying endoscopy, while 98. 8% (474/480) could be determined by FICE (P ＜0. 01 ). The structure and form of mucosal capillaries could be observed more clearly with FICE than with staining magnifying endoscopy (P ＜ 0. 01 ), but there was no significant difference between the two methods in showing pit pattern The rate of accordance with pathological diagnosis in FICE to differentiate non-neoplasm from neoplasm was 92. 2% (437/474), which was significanly higher than that of the staining magnifying endoscopy (81.0%, 389/480, P ＜ 0. 01 ). Results FICE is easy to manipulate and can be used to observe the mucosal microstructure and capillaries and it is superior to routine colonoscopy and magnifying staining technique in differentiating non-neoplasm from neoplasm in colon.