基于NICE分型的结直肠小息肉诊断临床研究

Clinical Study on the Diagnosis of Small Colorectal Polyps Based on NICE Staging

目的探讨基于窄带成像国际结肠内窥镜(Narrow-band Imaging International Colorectal Endoscopic,NICE)分型的结直肠小息肉诊断临床价值。方法选取2019年1月—2020年9月武汉科技大学附属汉阳医院内镜中心200例进行肠镜检查发现小息肉(直径≤10 mm)的患者作为研究对象。入院后,均行窄带成像(Narrow Band Imaging,NBI)放大肠镜检查,观察病灶位置、形态特征。与“金标准”病理检查相比,观察NICE分型标准下病灶分型情况及诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值。结果200例患者镜下共发现248个小息肉样病变,分布于直肠45个(18.15%)、横结肠61个(24.60%)、升结肠58个(23.39%)、乙状结肠40个(16.13%)、降结肠44个(17.74%);隆起型125个(50.40%)、平坦型病灶123个(49.60%)。病理学检查结果显示,248个小息肉样病变中,良性病灶191个(77.02%),恶性病灶57个(22.98%)。与病理检查相比,观察NICE分型标准下检出病灶灵敏度96.49%、特异度98.43%、准确度97.98%、阳性预测值94.83%、阴性预测值98.95%。结论结直肠小息肉样病变诊断中应用NICE分型法效果理想,可鉴别诊断息肉性质,了解息肉具体特征。

Objective To explore the clinical value of small colorectal polyp diagnosis based on narrow-band imaging international colorectal endoscopic(NICE)staging.Methods A total of 200 patients with small polyps(diameter≤10 mm)who underwent colonoscopy at the Endoscopy Center of Hanyang Hospital Affiliated to Wuhan University of Science and Technology from January 2019 to September 2020 were selected as the study objects.After admission,narrow band imaging(NBI)magnification colonoscopy was performed to observe the location and morphological characteristics of the lesions.Compared with the"gold standard"pathological examination,the classification of lesions and diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value under NICE classification were observed.Results A total of 248 small polypoid lesions were found in 200 patients,45 in rectum(18.15%),61 in transverse colon(24.60%),58 in ascending colon(23.39%),40 in sigmoid colon(16.13%),and 44 in descending colon(17.74%).There were 125 lesions of elevation type(50.40%)and 123 lesions of flat type(49.60%).Pathological examination showed that among 248 small polypoid lesions,191 were benign lesions(77.02%)and 57 were malignant lesions(22.98%).Compared with pathological examination,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 96.49%,98.43%,97.98%,94.83%and 98.95%respectively.Conclusion The application of NICE staging method in the diagnosis of small colorectal polypoid lesions is ideal,which can identify and diagnose the nature of polyps and understand the specific characteristics of polyps.