微探头超声内镜在大肠癌前病变中的诊断价值分析

The value of micro probe endoscopic ultrasonography in diagnosis of colorectal precancerous lesions in analysis

目的 :研究微探头超声内镜在大肠癌前病变中的诊断价值,为临床防治提供参考。方法 :选取2016年1月~2017年5月期间在我院接受结直肠镜检查的85例大肠息肉样病变患者作为研究对象,并均经病理检查诊断,共检出157个息肉样病变。所有患者均接受微探头超声内镜检查,将病理诊断结果作为金标准进行对比分析。结果 :157个息肉样病变内,62个为增生性/炎性息肉,81个为腺瘤,14个为腺癌;NBI显示病变的轮廓及表面结构、微血管形态清晰度显著优于普通内镜,差异有统计学意义;NICE分型显示,157个病变中:61个病变为Ⅰ型,80个病变为Ⅱ型,16个病变为Ⅲ型;微探头超声内镜检查大肠肿瘤性病变的敏感性及特异性、准确性分别是94.7%、90.3%、93.0%;与术后病理诊断分期对比,微探头超声内镜检查诊断大肠癌的T分期的总准确率是85.7%。结论 :微探头超声内镜在大肠癌前病变中的诊断价值高,能有效提高大肠癌前病变检出率,具有高度敏感性及特异性、准确性,值得临床推广。

Objective To study the diagnostic value of miniprobe endoscopic ultrasonography in the diagnosis of colorectal precancerous lesions, and provide reference for clinical prevention and treatment. Methods From January 2016 to May 2017 received 85 cases of colorectal polypoid lesions in patients with colonoscopy examination in our hospital as the research object, and were confirmed by pathological diagnosis, there were 157 polyps like lesions. All patients underwent micro probe endoscopic ultrasonography, the pathological diagnosis as the gold standard were analyzed. Results 157 polypoid lesions, 62 hyperplastic/inflammatory polyp, 81 adenoma, 14 of adenocarcinoma; NBI lesions The contour and surface structure, microvascular morphology definition was significantly better than that of ordinary endoscopy, the difference was statistically significant; NICE typing showed that 157 lesions: 61 lesions were type I, 80 lesions were type Ⅱ, 16 lesions were type Ⅲ; sensitivity and specificity of micro probe endoscopic ultrasonography check the large bowel tumor lesions, the accuracy was 94.7%, 90.3%, 93%; stage compared with the postoperative pathological diagnosis, micro probe endoscopic ultrasonography in diagnosis of colon cancer T staging accuracy rate of diagnosis is 85.7%. Conclusion Miniprobe endoscopic ultrasonography in the diagnosis of colorectal precancerous lesions. High value, can effectively improve the detection rate of colorectal precancerous lesions, with high sensitivity and specificity, accuracy, worthy of promotion.