高清晰非放大结肠镜窄波成像模式对结肠息肉样病变性质的诊断

Efficiency of NBI colonoscopy without optical magnification in the diagnosis of colorectal polypoid lesions

目的探讨高清晰结肠镜窄波成像(NBI)模式下黏膜表面血管形态(capillary pattern,CP)对结肠息肉样病变的病理组织类型的预测能力。方法 130例患者接受结肠镜检查诊断结肠息肉样病变175个,根据NBI下CP预测该病变为肿瘤性或非肿瘤性病变,并与病理结果对照判定其敏感性、特异性及准确率。结果普通结肠镜NBI下CP鉴别肿瘤性或非肿瘤性病变的敏感性为97.5%,特异性为83.7%,阳性预测值为84.2%,阴性预测值为96.3%,准确度为90.3%。对于小于5 mm的息肉的诊断敏感性为94.4%,特异性为95.7%,阳性预测值为89.5%,阴性预测值为97.8%,准确率为96.9%。大于5 mm息肉的诊断敏感性为98.5%,特异性为71.1%,阳性预测值为83.1%,阴性预测值为97.0%,准确率为87.3%。结论高清晰结肠镜NBI模式下观察息肉样病变CP形态对鉴别其为肿瘤性、非肿瘤性病变具有可靠的诊断价值。

【Objective】To investigate if NBI without optical magnification could help predict the histology of colorectal polypoid lesion.【Methods】A series of 130 patients with 175 colorectal lesions were studied.All lesions were detected by conventional colonoscopy and subsequently evaluated by NBI.During NBI,the microvascular architecture observed on the surface of the detected lesions,capillary patterns（CP） was divided into non-neoplastic（CP I） and neoplastic（CP II and CP III） types.【Results】The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of capillary patterns（CP） under NBI were 97.5%,83.7%,84.2%,96.3% and 90.3%.For lesions ≤5 mm,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of capillary patterns（CP） under NBI were 94.4%,95.7%,89.5%,97.8% and 96.9%.For lesions5 mm,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of capillary patterns（CP） under NBI were 98.5%,71.1%,83.1%,97.0% and 87.3%.【Conclusions】Capillary patterns observed by NBI without optical magnification could be used to assess the neoplastic or non-neoplastic lesion in colonic polypoid lesions.