内镜下血红蛋白指数色图测定诊断大肠病变的价值

Value of IHb map in the diagnosis of colorectal lesions

目的探讨血红蛋白指数（IHb）色图测定对大肠病变的诊断价值。方法采用电子肠镜对267例患者进行观察，在选择的相应区域记录IHb色图，并取活检组织行病理学检查，同时采用免疫组织化学染色方法计数微血管密度（MVD）。结果与周边黏膜相比，炎性息肉及腺瘤性息肉IHb值高，而增生性息肉IHb值比周边稍低或差别不大，但比炎性息肉IHb值低（P〈0．01）；炎症浸润重的黏膜IHb值比正常黏膜高（P〈0．05）；肿瘤的IHb值多明显高于癌周黏膜，高分化腺癌的IHb值高于低分化腺癌（P〈0．05）；IHb值高的区域其MVD也较高（P〈0．01）。结论结肠镜下IHb色图测定操作简单，对病灶性质的判断、病灶范围的确定、微小病灶的检出和指导内镜治疗有一定的临床意义。

Objective To evaluate the value of IHb map in colorectal lesions. Methods IHb map images was observed in 267 patients with colorectal lesions using colonoscopy. Biopsies were taken and microvessel density （MVD） were examined by immunohistochemical staining. Results Colorectal polyps were found in 133 patient,IHb values were higher in inflammatory and adenomatous polyps, and IHb values of hyperplastic polyps were significantly lower than that of inflammatory polyps（ P 〈0.01 ）. IHb values were higher in the specimens of more inflammatory cell infiltration than normal mucosa （ P 〈 0. 05）. IHb values seemed to be related to tumor differentiation. An increased IHb values was more frequently observed in differentiated carcinoma than in undifferentiated carcinoma（ P 〈 0. 05 ）. The higher of IHb values,the higher of MVD （P 〈 0. 01 ）. Conclusion To operate IHb map is simple, measurement of IHb map is useful in detecting minimal lesion in colorectal lesions, distinguishing the benign from the malignant, determining the extent of the lesion and do endoscopic treatment timely.