息肉标本预处理方法对高分辨率显微内镜成像效果的影响

Affect of different pretreatment methods of polyp specimens on high-resolution microendoscopic imaging

目的比较结肠息肉标本不同预处理方法对高分辨率显微内镜成像效果的影响。方法选择90例离体结肠息肉标本,随机分为3组,分别使用生理盐水(A组)、生理盐水+去黏液剂(B组)、生理盐水+去黏液剂+高渗糖溶液(C组)冲洗,预处理结肠息肉标本后分别进行高分辨率显微内镜成像观察,然后行病理学检查,比较三组图片质量,并与病理结果对照,分析诊断的准确率。结果每组息肉标本获得高分辨率显微内镜图片900张,A组优质图片317张,优质率为35.2%,B组优质图片493张,优质率为54.8%,C组优质图片564张,优质率为62.7%,差异具有统计学意义(P<0.05)。与病理检查对比,A组同时诊断为腺瘤性息肉9例、非腺瘤性息肉8例,诊断准确率为56.7%;B组同时诊断为腺瘤性息肉13例、非腺瘤性息肉7例,诊断准确率为66.7%;C组同时诊断为腺瘤性息肉12例、非腺瘤性息肉15例,诊断准确率为90.0%,高分辨率显微内镜诊断结肠息肉总体准确率为71.1%,C组与A组相比、C组与B组相比,差异均具有统计学意义(P<0.05)。结论使用生理盐水+去黏液剂+高渗糖溶液处理标本可以提高高分辨率显微内镜诊断准确性。

Objective To verify the effect of high-resolution microendoscopic imaging and to compare the effects of different pretreatment methods for colon polyps specimens in high-resolution microendoscopic imaging and the accuracy of the diagnosis of dis- ease. Methods In vitro specimens from 90 patients with colon polyps were randomly divided into three groups ： using saline （ group A）, saline plus mucus removing agent （group B）, saline, and mucus removing agent plus hypertonic glucose solution （group C） to wash and high-resolution microscopic imaging was made for pretreated specimens of colon polyps and then for pathological examination. The picture quality of the three groups was analyzed. Results Tile high-resolution microscopic images are 900 for specimens in each polyp, high-quality images in group A were 317 and high quality rate was 35.2% ; high-quality images in group B were 493 and high quality rate was 54.8% ; and high-quality images in group C were 564 and high quality rate was 62.7% , the difference was statistically significant （P 〈 0.05 ）. Compared with the pathological examination, group A showed simultaneous diagnosis of adenomatous polyps in 9 cases, 8 cases of non-adenomatous polyps, with diagnostic accuracy of 56.7% ;group B showed simultaneous diagnosis of adenoma- tous polyps in 13 cases, non-adenomatous polyps in 7 cases, with diagnostic accuracy of 66.7% ; and group C showed simultaneous di- agnosis of adenomatous polyps in 12 cases, non-adenomatous polyps in 15 cases, with diagnostic accuracy of 90.0%. The overall ac- curacy of high-resolution microendoscopy in diagnosis of colon polyps was 71.1%. In Group C, compared with group A, and compared with group B. The difference was statistically significant （P 〈 0.05）. Conclusions High-resolution microendoscopy has good imaging results for polyp specimens after pretreatment. It can improve the picture quality and diagnostic accuracy before imaging using saline combined with mucus removing agent and hypertonic glucose solution.