CAJ | 학술논문

目的探讨窄带成像放大内镜(NBI-ME)鉴别大肠肿瘤性与非肿瘤性病变表面网状微血管结构改变的临床价值.方法选择常规内镜检出大肠肿瘤性、非肿瘤性病变144处(102例),记录NBI-ME观察病变表面微血管结构(CP)形态和染色放大内镜观察病变黏膜表面腺管开口(pit)形态.分析pit周围CP形态变化,比较两者形态间的关系.所有病变经内镜或手术治疗后行组织病理学检查.结果常规内镜鉴别病变是否为肿瘤性的准确率75.7%、敏感性85.1%、特异性40.0%,明显低于NBI-ME和染色放大内镜(P＜0.005),NBI-ME和染色放大内镜间则未见差异.CP分型与pit分型对照,CP-Ⅰ型、Ⅱ型、Ⅳ型、Ⅵa型分别与pit Ⅰ型、Ⅱ型、Ⅳ型、ⅤI型间一致性达100%.144处病变中,内镜治疗129处,手术治疗15处.组织病理学检查:非肿瘤性30处(增生性息肉17处、炎症性息肉13处);肿瘤性114处(腺瘤95处、腺癌19处).结论初步显示NBI-ME和染色放大内镜之间具有正相关性,两种检查方法互补可作为当前鉴别大肠病变是否为肿瘤性的重要手段.
목적 탐토착대성상방대내경(NBI-ME)감별대장종류성여비종류성병변표면망상미혈관결구개변적림상개치.방법 선택상규내경검출대장종류성、비종류성병변144처(102례),기록NBI-ME관찰병변표면미혈관결구(CP)형태화염색방대내경관찰병변점막표면선관개구(pit)형태.분석pit주위CP형태변화,비교량자형태간적관계.소유병변경내경혹수술치료후행조직병이학검사.결과 상규내경감별병변시부위종류성적준학솔75.7%、민감성85.1%、특이성40.0%,명현저우NBI-ME화염색방대내경(P＜0.005),NBI-ME화염색방대내경간칙미견차이.CP분형여pit분형대조,CP-Ⅰ형、Ⅱ형、Ⅳ형、Ⅵa형분별여pit Ⅰ형、Ⅱ형、Ⅳ형、ⅤI형간일치성체100%.144처병변중,내경치료129처,수술치료15처.조직병이학검사:비종류성30처(증생성식육17처、염증성식육13처);종류성114처(선류95처、선암19처).결론 초보현시NBI-ME화염색방대내경지간구유정상관성,량충검사방법호보가작위당전감별대장병변시부위종류성적중요수단.
Objective To observe the meshed capillary pattern(CP)on the surface of colorectal lesions by narrow-band imaging system with magnifying endoscopy(NBI-ME),and to distinguish neoplasm from non-neoplasm by the change of capillary patterns.Methods A total of 144 colorectal lesions in 102 patients detected by conventional colonoscopy were evaluated by NBI-ME to observe the CP on surface,and by staining magnifying colonoscopy to observe the pit pattern.Results All lesions were resected endoscopically (129/144)or by surgery(15/144),and the pathological evaluation diagnosed 30 cases of non-neoplasm (including 20 cases of hyperproliferative polyps and 10 of inflammatory polyps)and 1 14 cases of neoplasm (including 95 cases of adenoma and 19 cases of adenocarcinoma).The diagnostic accuracy rate,sensitivity and specificity of conventional colonoscopy were 75.7%,85.1%and 40.O%,respectively,which were significantly lower than those of NBI-ME and staining magnifying colonoscopy(P＜0.005),while there was no significant difference between NBI-ME and staining magnifying colonoscopy.The CP of type Ⅰ,Ⅱ,Ⅳ and Ⅵa were totally correspondent with pit pattern of type Ⅰ,Ⅱ,Ⅳ and ⅤI. Conclusion NBI-ME findings of colorectal lesions correlated with those of staining magnifying colonoscopy.These two techniques are both helpful in differentiating colorectal neoplasms from non-neoplasms.