窄光谱成像技术的临床应用价值

The value of clinical application of narrow-band imaging endoscopy

目的探讨窄光谱成像技术(NBI)的临床应用价值。方法使用传统普通肠镜(白光模式)及NBI模式下分别对220处大肠增生性病灶进行观察、诊断,并取病理活检,对比NBI与传统肠镜诊断大肠增生性病变性质的准确性。总结NBI下大肠各种增生性病灶的腺管开口特点。结果 NBI诊断大肠增生性病灶的准确率明显高于传统肠镜,病理符合率达85.5%,高于传统肠镜73.6%,(P<0.05);NBI下大肠炎性增生的腺管开口多为Ⅰ、Ⅱ型(96.7%),腺瘤多为Ⅱ、Ⅲ型(79.7%),早癌的腺管开口可为Ⅲ(20.0%)、Ⅳ(73.3%)和Ⅴ型(6.7%),进展期肿瘤多为Ⅴ型开口(90.7%)。结论 NBI较传统肠镜更能预测大肠增生性病灶的性质,提高早癌检出率。

Objective To evaluate the clinical usefulness of narrow-band imaging（NBI）.Methods A total of 220 cases with proliferative lesions of large bowel was examined with white light and NBI endoscopy. Biopsies were taken for pathologic diagnosis.The accordance rate of diagnosis was compared between the results of NBI and conventional enteroscopy.The pit patterns of the lesions were inspected by NBI. Results The accordance rate of diagnosis for colorectal proliferative lessions and early-stage cancer by NBI was higher than that by conventional enteroscopy（85.5% vs. 73.6%）（P0.05）.The pit pattern of colorectal inflammatory hyperplasia was mainly demonstrated as grade Ⅰ/Ⅱ（96.7%）,adenoma as grade Ⅱ/Ⅲ（79.7%） and the early-stage cancer as grade Ⅲ（20.0%）,Ⅳ（73.3%） and Ⅴ（6.7%）.While progressive cancer was mainly as grade Ⅴ（90.7%）.Conclusion NBI is obviously superior to conventional enteroscopy in predicting the pathological character of colorectal proliferative lesions and early-stage cancer.