中华消化内镜杂志
中華消化內鏡雜誌
중화소화내경잡지
CHINESE JOURNAL OF DIGESTIVE ENDOSCOPY
2010年
10期
522-525
,共4页
李明阳%朱敏%杨云生%王志强%张子其
李明暘%硃敏%楊雲生%王誌彊%張子其
리명양%주민%양운생%왕지강%장자기
共焦显微镜检查%腺癌%诊断%评价研究
共焦顯微鏡檢查%腺癌%診斷%評價研究
공초현미경검사%선암%진단%평개연구
Confocal microscopy%Adenocarcinoma%Diagnosis%Evaluation studies
目的 通过共聚焦激光显微内镜(CLE)观察大肠管状腺癌的镜下组织学特点,制定高、中、低分化腺癌的诊断依据,评价CLE诊断大肠管状腺癌的价值.方法 首先对12个经病理证实为大肠管状腺癌的病变(高分化腺癌4个,中分化腺癌4个、低分化腺癌4个)进行CLE图像分析,制定CLE诊断管状腺癌的依据.然后应用该依据对49个大肠肿物进行前瞻性CLE诊断,最终将CLE诊断结果与病理诊断结果作比较,评价CLE的诊断效率.结果 CLE诊断管状腺癌的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为94.7%、90.9%、93.9%、100.0%和76.9%;CLE诊断高分化腺癌的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为100%、83.3%、8 8.9%、85.7%和87.0%;CLE诊断中分化腺癌的敏感度、特异度、准确率阳性预测值和阴性预测值分别为86.7%、90.5%、86.1%、86.7%和90.5%;CLE诊断低分化腺癌的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为77.8%、92.6%、88.9%、100.0%和86.2%.结论 共聚焦激光显微内镜可以诊断大肠管状腺癌,并能够对大肠管状腺癌进行分级诊断.CLE可以成为一种诊断大肠管状腺癌的新工具.
目的 通過共聚焦激光顯微內鏡(CLE)觀察大腸管狀腺癌的鏡下組織學特點,製定高、中、低分化腺癌的診斷依據,評價CLE診斷大腸管狀腺癌的價值.方法 首先對12箇經病理證實為大腸管狀腺癌的病變(高分化腺癌4箇,中分化腺癌4箇、低分化腺癌4箇)進行CLE圖像分析,製定CLE診斷管狀腺癌的依據.然後應用該依據對49箇大腸腫物進行前瞻性CLE診斷,最終將CLE診斷結果與病理診斷結果作比較,評價CLE的診斷效率.結果 CLE診斷管狀腺癌的敏感度、特異度、準確率、暘性預測值和陰性預測值分彆為94.7%、90.9%、93.9%、100.0%和76.9%;CLE診斷高分化腺癌的敏感度、特異度、準確率、暘性預測值和陰性預測值分彆為100%、83.3%、8 8.9%、85.7%和87.0%;CLE診斷中分化腺癌的敏感度、特異度、準確率暘性預測值和陰性預測值分彆為86.7%、90.5%、86.1%、86.7%和90.5%;CLE診斷低分化腺癌的敏感度、特異度、準確率、暘性預測值和陰性預測值分彆為77.8%、92.6%、88.9%、100.0%和86.2%.結論 共聚焦激光顯微內鏡可以診斷大腸管狀腺癌,併能夠對大腸管狀腺癌進行分級診斷.CLE可以成為一種診斷大腸管狀腺癌的新工具.
목적 통과공취초격광현미내경(CLE)관찰대장관상선암적경하조직학특점,제정고、중、저분화선암적진단의거,평개CLE진단대장관상선암적개치.방법 수선대12개경병리증실위대장관상선암적병변(고분화선암4개,중분화선암4개、저분화선암4개)진행CLE도상분석,제정CLE진단관상선암적의거.연후응용해의거대49개대장종물진행전첨성CLE진단,최종장CLE진단결과여병리진단결과작비교,평개CLE적진단효솔.결과 CLE진단관상선암적민감도、특이도、준학솔、양성예측치화음성예측치분별위94.7%、90.9%、93.9%、100.0%화76.9%;CLE진단고분화선암적민감도、특이도、준학솔、양성예측치화음성예측치분별위100%、83.3%、8 8.9%、85.7%화87.0%;CLE진단중분화선암적민감도、특이도、준학솔양성예측치화음성예측치분별위86.7%、90.5%、86.1%、86.7%화90.5%;CLE진단저분화선암적민감도、특이도、준학솔、양성예측치화음성예측치분별위77.8%、92.6%、88.9%、100.0%화86.2%.결론 공취초격광현미내경가이진단대장관상선암,병능구대대장관상선암진행분급진단.CLE가이성위일충진단대장관상선암적신공구.
Objective To establish diagnostic standards of colorectal tubular adenocarcinoma with confocal laser endomicroscopy(CLE), and to evaluate its diagnostic value in vivo.Methods The confocal images of 12 cases, which were pathologically confirmed colorectal tubular adenocarcinoma(4 well differentiated, 4 moderately differentiated and 4 poorly differentiated), were collected and analyzed to establish diagnostic standards of the disease with CLE.Then 49 lesions were prospectively evaluated based on CLE standards,which were compared to histopathology results.Results The sensitivity, specificity, accuracy, positive predictive value(PV +)and negative predictive value(PV -)of CLE in diagnosing tubular adenocarcinoma were 94.7%, 90.9%, 93.9%, 100% and 76.9%, respectively.The corresponding data of well differentiated adenocarcinoma were 100%, 83.3%, 88.9%, 85.7% and 87.0%, those of moderately differentiated adenocarcinoma were 86.7%, 90.5%, 86.1%, 86.7% and 90.5%, and those of poorly differentiated adenocarcinoma were 77.8%, 92.6%, 88.9%, 100% and 86.2%.Conclusion CLE is able to diagnose and grade colorectal tubular adenocarcinoma.
