内镜窄带成像放大技术和色素染色对早期结直肠癌及其癌前病变的诊断研究

Endoscopic Narrow-band Imaging Magnification and Pigment Staining in the Diagnosis of Early Colorectal Cancer and its Precancerous Lesions

目的研究内镜窄带成像放大技术和色素染色对早期结直肠癌及其癌前病变检出率的临床价值。方法2016年11月-2018年10月期间方便选取在该院门诊及住院接受结肠镜检查的疑似早期结直肠癌和癌前病变患者60例,分别在普通模式以及内镜NBI模式+染色放大内镜下行电子内镜观察结肠黏膜的变化,比较两种检查模式对早期结直肠癌及其癌前病变诊断的敏感度、特异度及准确度。结果60例CRC部位分别为直肠、乙状结肠、降结肠、横结肠、升结肠、盲肠;普通模式下诊断准确率为46.0%,内镜NBI模式+染色放大内镜诊断准确率为84.0%,差异有统计学意义(χ^2=31.736,P<0.05)。结论NBI放大内镜和染色放大内镜能更为清晰地显示早期病变形态、范围,腺管开口形态,微血管形态,且操作转换简单快捷,两种检查方法互补可作为当前鉴别早期大肠病变是否为肿瘤性的重要手段。

Objective To study the clinical value of endoscopic narrow-band imaging magnification and pigment staining for the detection rate of early colorectal cancer and its precancerous lesions.Methods Convenient selection of sixty patients with suspected early colorectal cancer and precancerous lesions who underwent colonoscopy at our hospital in outpatient and inpatient settings from November 2016 to October 2018 underwent electronic endoscopy in ordinary mode as well as in endoscopic NBI mode+stained magnification endoscopy to observe changes in the colonic mucosa,respectively,to compare the sensitivity,specificity and accuracy of the two examination modes for the diagnosis of early colorectal cancer and its precancerous lesions.Results The CRC sites of 60 cases were rectum,sigmoid colon,descending colon,transverse colon,ascending colon,and cecum.The diagnostic accuracy rate in normal mode was 46.0%,and the diagnostic accuracy rate in endoscopic NBI mode+staining magnifying endoscopy was 84.0%,the difference was statistically significant(χ^2=31.736,P<0.05).Conclusion NBI magnification endoscopy and staining magnification endoscopy can more clearly show the morphology and extent of early lesions,the morphology of glandular duct opening and microvascular morphology,and the conversion is simple and fast.