窄带成像技术下NICE分型对直乙结肠微小息肉的诊断价值

Value of NICE Classifi cation with NBI in Predicting Diminutive Rectosigmoid Polyps

目的：探讨窄带成像技术（NBI）下应用国际结直肠内镜分型（NICE）对直乙结肠微小息肉（≤5 mm）的实时诊断价值。方法在非放大内镜NBI模式下对直乙结肠微小息肉进行观察，根据NICE分型实时预测息肉的病理性质，并与组织病理学检查结果进行对比分析。结果117枚直乙结肠息肉中微小息肉75枚。NICE分型诊断肿瘤性和非肿瘤性息肉的准确率、敏感度、特异度、阳性预测值和阴性预测值分别为93.16%、95.71%、89.36%、93.06%和93.33%；对于微小息肉， NICE分型诊断肿瘤性和非肿瘤性病变的准确率、敏感度、特异度、阳性预测值和阴性预测值分别为90.67%、91.67%、89.74%、89.19%和92.11%。结论 NBI内镜下应用NICE分型能够比较准确地鉴别直乙结肠微小息肉的肿瘤性和非肿瘤性病变，对腺瘤的阴性预测值≥90%。

Objective To explore the diagnostic efficacy of narrow-band imaging （NBI） in real-time predicting histology of diminutive rectosigmoid polyp （≤5 mm）, using narrow-band imaging international colorectal endoscopic （NICE） classifi cation.Methods The histology of all polyps≤5 mm was predicted in vivo according to NICE classifi cation, by using NBI without optical magnifi cation. The results were then compared with pathological findings.Results 117 rectosigmoid polyps from 70 patients were found, of which 75 were diminutive. Accuracy, sensitivity, specificity, positive and negative predictive values of NICE classification in differentiating colorectal neoplastic and non-neoplastic polyps were 93.16%, 95.71%, 89.36%, 93.06% and 93.33%, respectively. When limited to polyps≤5 mm, the accuracy, sensitivity, specifi city, positive and negative predictive values of NICE classifi cation were 90.67%, 91.67%, 89.74%, 89.19% and 92.11%. Conclusion NICE classifi cation with NBI is accurate in differentiating neoplastic from non-neoplastic rectosigmoid polyps≤5 mm, with the negative predictive value≥90%.