摘要
目的分析醋酸染色后窄带成像(NBI)内镜下大肠腺瘤和早期大肠癌的黏膜表面腺管形态(pit)、微血管形态(cp)、黏膜白化时间的特征,评价其预测低级别上皮内瘤变、高级别上皮内瘤变和早期癌的价值。方法用醋酸染色后NBI的方法观察大肠可疑病变,根据pit分型、cp分型、黏膜白化时间预测病变为低级别上皮内瘤变、高级别上皮内瘤变和早期癌,并与病理结果对照判断其敏感度、特异度、准确率、阳性预测值、阴性预测值。结果入选106例病例。pit分型ⅢL或Ⅳ型,联合cp分型Ⅱ型和醋酸白化时间31～60 s预测低级别上皮内瘤变敏感度、特异度、准确率分别为87.2%、89.3%、87.7%;pit分型ⅤI型,联合cp分型ⅢA型和醋酸白化时间6～30 s预测高级别上皮内瘤变和早期癌的敏感度、特异度、准确率分别为82.1%、83.3%、83.0%。结论醋酸染色后NBI观察大肠可疑病灶的微形态,两种方法结合,取长补短,能清晰显示病灶pit和cp,具有视野清晰、价格低廉、操作简单、无毒的优点,对鉴别低级别上皮内瘤变、高级别上皮内瘤变和早期癌有较高价值,值得推广应用。
Objective To analyze the characteristics of morphological （pit） , microvascular （cp） and mucosa whit ening time in coloreetal adenoma and early carcinoma under narrow band imaging （NBI） after acetic acid spray, and tc evaluate the predictive ability on the low grade intraepithelial neoplasia, the high grade intraepithelial neoplasia and ear ly carcinoma. Methods According to pit, cp and mucosa whitening time, NBI was used after acetic acid spray to ob- serve colorectal suspicious lesions and forecast the low grade intraepithelial neoplasia, the high grade intraepithelial neo plasia and early carcinoma. Then compared with pathology results, their degree of sensitivity, specificity, accuracy, positive predictive value and negative predictive value were determined. Results 106 patients were enrolled. The pil type Ⅲ or Ⅳ, ep type Ⅱ, and mucosa whitening time 31 - 60 s forecasted low grade intraepithelial neoplasia, the sen sitivity, specificity and accuracy were 87.2% , 89.3% and 87.7% respectively. The pit type V 1 cp type Ⅲ and mu cosa whitening time 6 - 30 s forecasted high grade intraepithelial neoplasia and early carcinoma, the sensitivity, specific ity and accuracy were 82.1% , 83.3% and 83.0% respectively. Conclusion NBI after acetic acid helps observed mi cro-morphology of colorectal suspicious lesions. It clearly shows lesion＇ s pit and cp have the vision clear by combinin and complementing two ways. It has the advantages of cheapness, simpleness, non-toxin. In the differentiation of low grade intraepithelial neoplasia, high grade intraepithelial neoplasia and early cancers have higher value, worthy of repli. cation.
出处
《胃肠病学和肝病学杂志》
CAS
2013年第6期520-523,共4页
Chinese Journal of Gastroenterology and Hepatology
基金
上海市浦东新区科技发展基金资助(PKJ2011-Y07)
关键词
醋酸染色
窄带成像内镜
腺管形态
微血管形态
黏膜白化时间
低级别上皮内瘤变
高级别上皮内瘤变了早期癌
Acetic acid spray
Narrow band imaging （NBI）
Morphological
Microvascula
Mucosa whiteningtime
Low grade intraepithelial neoplasia
High grade intraepithelial neoplasia
Early carcinoma
