小儿结直肠息肉内镜诊断与病理结果一致性分析

An Analysis on the Consistency of Diagnostic Results with Pathological ones in Infantile Colorectal Polyps

目的:探讨小儿结直肠息肉内镜诊断与病理结果一致性。方法:选取我院2018年1月至2020年12月收治的78例疑是结直肠息肉患儿作为观察对象。所有患儿均进行内镜检查,并分析内镜检查结果,判断结直肠息肉的性质,根据内镜检查结果进行内镜切除或外科手术切除,将切除组织送病理检查,以病理检查结果作为金标准,分析内镜对患儿结直肠息肉的诊断效能。结果:在78例疑是结直肠息肉患儿中,经病理检查结果显示有76例确诊为结直肠息肉,病理诊断良性73例,恶性3例,内镜诊断良性71例与其一致,另有2例误诊为恶性,3例恶性与病理诊断结果一致;术后病理诊断结果显示,3例恶性病变患儿中有1例T1a期,2例T1b期,内镜诊断结直肠息肉恶性病变T1a期诊断符合率为50.00%、T1b期诊断符合率为66.67%。内镜诊断小儿结直肠息肉的灵敏度为100.00%,特异度为97.26%,准确率为97.37%,阳性预测价值60.00%,阴性预测价值100.00%,内镜诊断结果与病理诊断一致性(Kappa=0.737,P<0.001)。结论:对小儿结直肠息肉采用内镜检查,有助于鉴别良恶性结直肠息肉,其诊断性较高,利于临床制定科学合理的治疗方案,改善预后。

Objective To explore the consistency of diagnostic results with pathological ones in infantile colorectal polyps.Methods Enrolled the 78infantile patients suspected having colorectal polyps treated in authors'hospital(2018-01-2020-12)into this study:they all received endoscopy,then the results were analysed so as to judge polyps'characters,further according to which the patients received endoscopic resection or surgical treatment;Also,then the resected tissue was examined pathologically;then took pathological results as gold-standard,analysed the diagnostic efficiency of endoscopy on colorectal polyps.Results In the 78cases,76were confirmed as colorectal polyps by pathological exam.(including 73of benign polyps,3of malignant ones),meanwhile,endoscopy showed 71being benign,rest two cases as malignant;but 3being malignant were consistency with pathological exam.postoperatively pathological exam.results showed in the 3cases being malignant 1case was at T1astage;2cases,at T16stage were 66.67%.The sensitivity,specificity,accurate rate,positive prognosing value,and negative prognosing value of endoscopy diagnosis were respectively 100.00%,97.26%,97.37%,60.00%,and 100.00%;the consistency of endoscpy diagnosis with pathological diagnosis:Kappa=0.737,P<0.001.Conclusion For infantile colorectal polyps performing endoscopy is helpful to differentiating benign lesions from malignant ones,with high diagnosis outcome,also is beneficial to clinical development of rational scientific treatment schema,and improve prognosis.