JNET分型在结直肠肿瘤性病变诊断中的价值

Diagnostic value of JNET classification for colorectal neoplasms

目的评估窄带成像放大内镜（ME-NBI）下应用JNET分型诊断结直肠肿瘤性病变的临床价值。方法在ME-NBI模式下对结肠镜检查发现的110处结直肠新生性病变进行观察，分析病变的血管形态及表面结构变化，根据ME-NBI分型系统（JNET分型、Kudo分型）初步判断病变的性质，并与切除标本的病理结果进行对比分析。 结果ME-NBI下JNET分型总体分型诊断结直肠肿瘤性病变的敏感度、特异度、阳性预测值、阴性预测值和准确率分别为96.2%（75/78）、93.8%（30/32）、97.4%（75/77）、90.9%（30/33）和95.5%（105/110），Kudo分型总体分型的上述指标结果分别为92.3%（72/78）、81.3%（26/32）、92.3%（72/78）、81.3%（26/32）和89.1%（98/110），两者在诊断准确率上差异无统计学意义（P＝0.077）。JNET分型总体分型诊断微小息肉（≤0.5 cm）、小息肉（〉0.5～1.0 cm）、大息肉（〉1.0 cm）肿瘤性的准确率分别为92.3%（36/39）、93.8%（15/16）和98.2%（54/55），三者间差异无统计学意义（P＝0.379）。结论ME-NBI下JNET分型在鉴别结直肠病变肿瘤性与非肿瘤性方面具有较可靠的诊断价值。

bjectiveTo evaluate the clinical value of JNET classification using magnifying endoscopy with narrow-band imaging （ME-NBI） on diagnosis of colorectal neoplastic lesions.MethodsA total of 110 colorectal neoplastic lesions detected by conventional colonoscopy were assessed by ME-NBI, and the histology was predicted according to characteristics of vessel pattern and surface pattern with JNET classification and Kudo classification, respectively. The results were compared with actual histologic findings of these lesions. ResultsThe diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of overall JNET classification with ME-NBI for colorectal neoplastic lesions was 96.2%（75/78）, 93.8%（30/32）, 97.4%（75/77）, 90.9%（30/33）, and 95.5%（105/110）, respectively. The corresponding indicators of overall Kudo classification with ME-NBI was 92.3%（72/78）, 81.3%（26/32）, 92.3%（72/78）, 81.3%（26/32）, and 89.1%（98/110）, respectively, with no significant difference compared to JNET classification （P=0.077）. Diagnostic accuracy of JNET classification was 92.3%（36/39） in the polyps with diameter of 1 to 5 mm, 93.8%（15/16） in the polyps with diameter of 6 to 10 mm, 98.2%（54/55） in the polyps with diameter more than 10 mm, and those diagnostic accuracies had no significant difference（P=0.345）.ConclusionJNET classification with ME-NBI is effective in distinguishing neoplastic from non-neoplastic colorectal lesions.