内镜窄带成像技术及超声内镜联查在结直肠癌及癌前病变诊治中的应用

Combination of narrow-band imaging and endoscopic ultrasound in the diagnosis and treatment of colorectal cancers and precancerous lesions

目的探讨内镜窄带成像技术及超声内镜联查在结直肠癌及癌前病变诊治中的临床应用价值。方法选取2016年1月至2017年10月间辽宁省抚顺市中心医院收治的53例结直肠肿瘤患者进行回顾性分析,以内镜下切除或手术切除病变病理结果为诊断金标准,比较结直肠肿瘤患者内镜窄带成像技术(NBI)及超声内镜检查结果的临床应用价值。结果 53例结直肠肿瘤患者的NBI检查结果均能清晰显示Ⅱ～Ⅴ型息肉腺管开口形态,NBI肠镜对结直肠恶性肿瘤与非恶性肿瘤性病变的敏感性为100. 0%。21例腺瘤性息肉均来源于黏膜层行内镜下黏膜切除术(EMR),32例结直肠癌患者均行外科手术治疗。内镜超声对结直肠癌浸润深度判断的总准确率为78. 1%。结论 NBI能对结直肠隆起病变的黏膜腺管开口进行分类,可判断病变的肿瘤性与非肿瘤性,联合超声内镜能对病变的起源进行准确的判断,对治疗方案的选择具有明确的临床指导价值。

Objective To evaluate the use of narrow-band imaging( NBI) system combined with endoscopic ultrasound in the diagnosis and treatment of colorectal cancers and precancerous lesions.Methods A total of 53 patients with colorectal tumors treated at Center Hospital of Fushun from January2016 to October 2017 were retrospectively analyzed. Endoscopic resection or surgical removal of pathological findings lesions were considered as the gold standard. The clinical application value of NBI and endoscopic ultrasound were compared. Results The NBI detection results for 53 patients could reveal Ⅱ-Ⅴpolyp morphology duct opening. Sensitivity of NBI colonoscopy was 100. 0% for colorectal cancer and non-malignant lesions. Endoscopic mucosal resection( EMR) was performed for 21 adenomatous polyp. A total of 32 patients with colorectal cancers underwent surgery. Overall diagnostic accuracy of EUS for the depth of invasion of colorectal cancer was 78. 1%. Conclusion Narrow-band imaging has better sensitivity in detection of mucosal gland opening caused by colorectal elevated lesion and can distinguish carcinoma from non-carcinoma colorectal lesion. Combination of endoscopy ultrasonography can accurately judge the origin of disease. It has obvious clinical guidance value for selecting treatment regimens.