普通内镜结合靛胭脂染色在鉴别瘤性与非瘤性大肠息肉中的价值

Value of routine colonoscopy combined with indigocarmine dyeing in identifying neoplastic from non-neoplastic colorectal polyps

目的探讨普通内镜结合靛胭脂染色在鉴别瘤性与非瘤性大肠息肉中的价值。方法对124个大肠息肉分别行普通内镜及靛胭脂染色内镜诊断,若息肉表面呈沟槽状、脑回状或分叶状结构则定义为瘤性息肉,若表面光滑或有规则小圆点状小凹就定义为非瘤性息肉,并与组织学结果比较,比较2种内镜诊断方法鉴别瘤性与非瘤性大肠息肉的诊断准确率、特异性和敏感性。结果靛胭脂染色内镜鉴别瘤性与非瘤性大肠息肉的诊断准确率显著高于普通内镜(85.48% vs 70.16%,P<0.005)。染色内镜鉴别瘤性与非瘤性大肠息肉的敏感性和特异性分别为86.11%、84.62%,显著高于普通内镜的72.22%、67.31%(P<0.05)。结论普通内镜结合靛胭脂染色可较准确地鉴别瘤性与非瘤性大肠息肉,有助于实时指导内镜下对大肠息肉的处理方式。

To discuss the value of routine colonoscopy combined with indigocarmine dyeing in identifying neoplastic from non-neoplatic colorectal polyps. 124 colorectal polyps included in this study were examined by both routine colonoscopy and chromoscopy with indigocarmine. If a sulcus, gyrus or lobate pattern was observed on the surface of the polyp, it was classified as neoplastic polyp. If the surface of a polyp was smooth or there was a small round pattern, it was thought as non-neoplastic one. The results of colonoscopic examinations were compared with histology, and the diagnostic accuracy, sensitivity and specificity were compared between two different colonoscopic diagnosing methods, too. The diagnostic accuracy of chromoendoscopy with indigocarmine in identifying neoplastic from non-neoplastic colorectal polyps was significant higher than routine colonoscopy (85.48% vs 70.16%, P<0.005). The sensitivity and specificity of chromoendoscopy with indigocarmine were also significant higher than routine colonoscopy (86.11% vs 72.22%, 84.62% vs 67.31%, respectively, P<0.05). [Conclusions] Routine colonoscopy with indigocarmine dyeing could differentiate neoplastic polyps from non-neoplastic ones accurately, and it could help to guide treatment of colorectal polyps at the time of performing colonoscopy.