FICE技术在大肠病变腺管开口分型及毛细血管形态观察中的价值

Role of Fuji intelligent chromo endoscopy in observation of pit pattern and blood capillary form of colonic lesions

目的:探讨内镜智能分光比色技术(FICE)鉴别大肠肿瘤及非肿瘤性病变的价值.方法:选择2007-03/2008-05在我院行结肠镜检查发现大肠新生物及息肉样病变者245例,分别采用常规放大技术、FICE放大技术及染色放大技术对病变进行腺管开口分型及毛细血管形态观察,对病变作出诊断,并与病理组织学诊断相比较.结果:在245例患者中发现新生性病变480个,其中常规放大内镜较FICE放大模式发现病变差异有统计学意义(90.0%vs98.8%,P<0.01).FICE放大内镜比染色放大内镜更能清晰显示黏膜毛细血管结构形态(P<0.01),在显示腺管开口方面两者无统计学意义,且前者对大肠肿瘤性病变的诊断符合率、敏感性、特异性优于后者(92.2%vs81.0%,95.3%vs85.6%,88.4%vs75.6%,均P<0.01).结论:FICE放大内镜对大肠肿瘤性病变诊断符合率高,操作简单,具有良好的临床实用价值.

AIM：To compare Fuji intelligent chromo endoscopy（FICE）and staining techniques in differential diagnosis for colonic tumor and nontumor lesions. METHODS：From March 2007 to May 2008,245 patients with colon neoplasm or polypoid lesions were included.The patients underwent a magnifying ordinary colonoscopy,a magnifying FICE technique and magnifying staining technique.The pit pattern and blood capillary form of the lesions were examined,an endoscopic diagnosis was made and compared with the pathologic diagnosis.RESULTS：A total of 480 neoplasms were detected in 245 patients.There was significant difference in detecting lesions between conventional magnifying endoscopy and FICE larger models（90.0%vs 98.8%,P〈0.01）.FICE magnifying endoscopy better revealed mucosal structure of capillaries than staining magnifying endoscopy （P〈0.01）,but there was not significant difference in revealing duct openings.FICE showed higher coincidence rate of diagnosis,higher sensitivity and specificity of the colorectal cancer than staining techniques（92.2%vs 81.0%,95.3% vs 85.6%,88.4%vs 75.6%,all P〈0.01）. CONCLUSION：FICE operates easily with higher coincidence rate of diagnosis and has a satisfactory clinical practical value in diagnosing colonic cancers.