高清电子染色技术在结肠息肉诊断中的价值

The value of I-SCAN technology for diagnosis of colorectal polyps

目的通过对比高清电子染色技术（I-SCAN）和普通高清电子结肠镜的结直肠息肉检出率和腺瘤检出率等，探讨该技术在诊断结直肠息肉中的应用价值。方法本研究为单中心、前瞻性、随机对照研究。采用随机数表法将研究对象随机分为2组。试验组及对照组在进镜过程中均采用普通高清模式，到达回肠末端或回盲部后试验组采用I-SCAN模式退镜观察，对照组仍采用普通高清模式。2组在进镜过程中对所发现的病变均不进行任何操作，在按照各自模式退镜时，对发现的疑似病变进行拍照及取活检等操作。所有标本均送病理诊断。比较2组的结直肠息肉检出率和结直肠腺瘤检出率。结果本研究最终共纳入患者228人，其中试验组115人，对照组113人。试验组和对照组的退镜时间分别为（7．3±3．6）min和（6．4±4．3）min，P=0．07。2组的肠道清洁度评分分别为（7．4±1．5）分和（7．4±2．3）分，P=0．942，以上差异均无统计学意义。所有的操作未发生任何并发症。试验组和对照组的结直肠息肉检出率分别为57．39％（66／115）和33．62％（38／113），差异有统计学意义（P=0．001）；腺瘤检出率分别为35．65％（41／115）和24．78％（28／113），差异无统计学意义（P=0．074）。结论I-SCAN组的结直肠息肉检出率显著高于普通高清电子内镜组，I-SCAN技术是一项拥有广阔前景的技术。

Objective To investigate the value of I-SCAN technology for diagnosis of colorectal pol- yps by comparing the difference of detection rate in polyp and adenoma between I-SCAN and normal high- definition endoscopy groups. Methods This study was a single-center, prospective, randomized case con- trolled study. The patients of two groups were allocated at random using the table of random numbers. The intubation procedures in experimental group were under normal high-definition mode while the withdrawal procedures were under I-SCAN mode. In the controlled group, all the procedures were under normal high- definition mode. The photographing and biopsy operation was done only in withdrawal procedures. All the le- sions were diagnosed by pathology. The polyp detection rate and adenoma detection rate were evaluated. Results A total of 228 patients were included in the study, 115 patients in experimental group while 113 in controlled group. There was no significant difference in withdraw time [ （7.3 ± 3.6 ）rain VS （6.4 ± 4. 3）min,P =0. 07] and the colon cleanliness[ （7.4 ± 1.5） VS （7.4 ±2. 3） ,P =0. 942] between the ex- perimental group and the controlled group. And there was no complication in either group. The detection rate of colorectal polyps of the experimental group was 57.39% （66/115 ）, while that of controlled group was 33. 62% （38/113 ）, with significant statistical difference（ P = 0. 001 ）. The detection rate of colorectal adeno- ma of the experimental group was 35.65% （41/115）, while that of the controlled group was 24. 78% （28/113）, with no significant difference （P = 0. 074 ）. Conclusion The polyp detection rate of I-SCAN group is higher than normal high-definition endoscopy group. I-SCAN has broad prospects.