窄带成像放大内镜在结直肠侧向发育型肿瘤中的应用价值

The clinical value of Narrow-band imaging magnifying endoscopy in the diagnosis of colorectal laterally spreading tumors

目的探讨窄带成像放大内镜(NBI-ME)在结直肠侧向发育型肿瘤(LST)中的诊断价值。方法回顾性分析2017年1月-2021年3月经内镜下或外科手术治疗的结直肠侧向发育型肿瘤患者的内镜图像,根据NBI-ME下病变表面微血管形态及微结构形态,重新进行JNET分型及Sano分型,内镜诊断与术后切除标本的病理诊断进行对比。结果ME-NBI下JNET分型诊断LST的敏感度、特异度、阳性预测值、阴性预测值分别为91.4%、88.0%、78.0%、95.7%,Sano分型上述指标结果分别为88.6%、81.3%、68.9%、93.8%;两者在诊断准确率上分别为89.1%、83.6%,差异无统计学意义(P=0.326)。两者在预测LST浸润深度总体准确率方面,JNET分型为80.9%,Sano分型为80.0%,差异无统计学意义。结论窄带成像放大内镜在结直肠侧向发育型肿瘤的诊断治疗中具有良好价值。

Objective To explore the diagnostic value of narrow-band imaging magnifying endoscopy(NBI-ME)in laterally developing colorectal tumors(LST).Methods The endoscopic images of patients with colorectal lateral developmental tumors treated by endoscopy or surgical operation from January 2017 to March 2021were retrospectively analyzed.According to the microvascular morphology and microstructure morphology of the lesion surface under NBI-ME,JNET typing and Sano typing were re-performed,and the endoscopic diagnosis was compared with the pathological diagnosis of postoperative excised specimens.Results The sensitivity,specificity,positive predictive value,and negative predictive value of JNET typing in the diagnosis of LST under ME-NBI were 91.4%,88.0%,78.0%,and 95.7%,respectively.The above-mentioned indexes of Sano typing were 88.6%,81.3%,68.9%,and 93.8%,respectively.The diagnostic accuracy rates of two methods were 89.1%and 83.6%respectively,and the difference was not statistically significant(P=0.326).In terms of the overall accuracy of predicting the depth of LST infiltration between two methods,the JNET typing was 80.9%,and the Sano typing was 80.0%,and the difference was not statistically significant.Conclusion Narrow-band imaging magnifying endoscopy has good value in the diagnosis and treatment of laterally developing colorectal tumors.