普通色素内镜在鉴别肿瘤性和非肿瘤性结直肠息肉的临床价值

Clinical value of common pigment endoscope in differentiating tumorous and non-tumorous colorectal polypi

目的探讨普通色素内镜结合Kudo分型在诊断肿瘤样和非肿瘤样结、直肠息肉的价值。方法对104例结、直肠息肉行常规内镜诊断后,在内镜下进行靛胭脂染色,结合Kudo分型,观察染色后息肉表面的细微结构,作出普通色素内镜诊断,并将普通内镜诊断、普通色素内镜诊断与病理组织学诊断进行比较,观察符合率。结果普通内镜下诊断肿瘤样和非肿瘤样结、直肠息肉与病理组织学诊断的符合率分别为29.2%和67.9%,总的病理符合率为50.0%。普通色素内镜虽不能清楚地进行kudo分类,但能将息肉表面结构形态分为三型:A型:点状或圆形;B型:管状、脑回型;C型:不规则结构。诊断为肿瘤性和非肿瘤性的结、直肠息肉与病理组织学诊断符合率分别为87.5%和85.7%,总的病理符合率为86.5%。结论普通色素内镜能较为准确地判断结、直肠息肉的性质,有效提高微小、扁平隆起型病灶的检出率,对结、直息肉进行实时诊断及治疗有重要价值。

Objective To discuss the value of common pigment endoscope combined with Kndo criteria in diagnosis of tumorous and non-tumorous colorectal polypi. Methods After conventional electronic endscopic diagnosis,a total of 104 colorectal polypi were dyed with indicarmine under endoscope, then their exterior micro-structure were observed with Kndo criteria and common pigment endoscopic and pathologic histology were observated for comparison with their coincidental rate. Results The coincidental rate with tumorous and non-tumorous colorectal polypin in common endoscope and pathologic histology were respectively 29.2% and 67. 9%. The total pathologic coincidental rate was 50.0%. Although it cannot be sorted with kndo criteria, common pigment endoscope can categorize the exterior structure into three types： type A：dot or round；type B： tubular,gyrus-like； type C： irregular.The coincidental rate for the diagnosis of tumorous and non-tumorous colorectal polypi in common pigment endoscope and pathologic histology were respectively 87.5% and 85.7%. The total pathologic coincidental rate was 86.5%. Conclusion By using common pigment endoscope,the quality of colorectal polypi can be judged more accuate,and the revealable rate for tiny, flat ridgy focus was enhanced effectively. It is suggests an important real diagnostic and remedial value for colorectal polypi.