CAJ | 학술논문

目的：评价窄带成像技术（ NBI ）普通内镜在大肠隆起样病变诊断中价值。方法应用NBI普通内镜观察了80例患者共103个大肠隆起样病变的表面腺管开口形态。根据工藤进英腺管开口形态分型法，将NBI内镜诊断结果与病理检查结果进行比较。结果普通肠镜发现隆起样病变的敏感性为80．0％（80/103），切换NBI后，能清楚显示隆起样病变的形态和边界，发现隆起样病变的敏感性为100％（103/103）；NBI普通内镜观察隆起样病变腺管开口，根据工藤进英腺管开口形态分型法进行诊断，其中腺管开口呈Ⅱ型18例，Ⅲ（ L）型54例，Ⅳ型15例，Ⅴ型16例。 NBI普通内镜对于大肠隆起性病变肿瘤及非肿瘤性的鉴别诊断的敏感性、特异性分别为95．3％（81/85）、83．3％（15/18）、NBI普通内镜对于大肠隆起性病变肿瘤及非肿瘤性的鉴别诊断的符合率为93．2％（96/103），与文献报道的NBI放大内镜的94.1％无统计学差异（ P＞0.05）。结论应用NBI普通内镜，也可以通过观察腺管开口形态，比较准确地鉴别诊断大肠肿瘤与非肿瘤病变。
목적：평개착대성상기술（ NBI ）보통내경재대장륭기양병변진단중개치。방법응용NBI보통내경관찰료80례환자공103개대장륭기양병변적표면선관개구형태。근거공등진영선관개구형태분형법，장NBI내경진단결과여병리검사결과진행비교。결과보통장경발현륭기양병변적민감성위80．0％（80/103），절환NBI후，능청초현시륭기양병변적형태화변계，발현륭기양병변적민감성위100％（103/103）；NBI보통내경관찰륭기양병변선관개구，근거공등진영선관개구형태분형법진행진단，기중선관개구정Ⅱ형18례，Ⅲ（ L）형54례，Ⅳ형15례，Ⅴ형16례。 NBI보통내경대우대장륭기성병변종류급비종류성적감별진단적민감성、특이성분별위95．3％（81/85）、83．3％（15/18）、NBI보통내경대우대장륭기성병변종류급비종류성적감별진단적부합솔위93．2％（96/103），여문헌보도적NBI방대내경적94.1％무통계학차이（ P＞0.05）。결론응용NBI보통내경，야가이통과관찰선관개구형태，비교준학지감별진단대장종류여비종류병변。
Objective To evaluate the efficacy of narrow band imaging ( NBI ) with routine endoscopy in diagnosis of colorectal protruding lesions .Methods A total of 103 colorectal protruding lesions from 80 patients were observed by NBI with routine endoscopy .These lesions were classified by pit pattern , which were then assesssed by reference to histopathology .Results The sensitivity of conventional colonoscopy in diagnosis of colorectal protruding lesions was 80%,which was increased to 100%under NBI , with the clear identification of the shape and boundary of the lesions .Pit pattern was analyzed according to gongtengs modified classification as follows:18 demonstratedⅡpit pattern,54Ⅲ( L) pit pattern,15Ⅳpit pattern,16Ⅴpit pattern.The diagnostic sensitivity and specificity of NBI with ordinary endoscopy in distinguishing neoplastic from non-neoplastic colorectal protruding lesions were 95.3% and 83.3%, respectively .The diagnostic accuracy was 93.2%, which was no significant difference with that of NBI magnifying endoscopy reported in the literature ( 94.1%) ( P >0.05 ). Conclusions NBI endoscopy without high magnification may also be useful to distinguish neoplastic from non-neoplastic colorectal protruding lesions by the observation of pit pattern .