摘要
目的探讨联动成像技术(LCI)结合化学染色技术对结直肠肿物Pit分型的诊断价值。方法回顾性分析2017年1月至2019年6月在南方医科大学深圳医院住院诊治,经结肠镜精查发现的310处结直肠肿物进行LCI结合化学染色观察,精细评估病灶表面的小凹形态,根据Pit分型(Pit pattern)预测病变的性质,与内镜下切除术后的病理结果进行对比分析。结果Ⅰ、Ⅱ和Ⅱ-O型诊断增生性息肉(HP)或锯齿状病变(SSP)的敏感度、特异度、阳性预测值(PPV)、阴性预测值(NPV)、准确率分别为58.8%、97.3%、55.6%、97.6%和95.2%。ⅢL和Ⅳ型诊断低度异型增生(LGD)、高度异型增生(HGD)的敏感度、特异度、PPV、NPV、准确率分别为92.9%、97.2%、94.3%、85.7%和92.9%。Ⅴi和Ⅴn型诊断黏膜内癌或黏膜下浸润癌但浸润深度小于1000μm(m-SMs)及黏膜下浸润癌浸润深度超过1000μm(SMd)的敏感度、特异度、PPV、NPV、准确率分别为90.6%、94.6%、65.9%、98.9%和94.2%。Ⅲs和Ⅴn型诊断SMd的敏感度、特异度、PPV、NPV、准确率分别为54.5%、97.7%、46.2%、98.3%和96.1%。结论LCI结合化学染色技术可以清楚勾勒结直肠肿物的Pit形态,可较好地区分其是否为肿瘤性病变,同时可以预判肿物的浸润深度,指导治疗方式的选择。
Objective To investigate the diagnostic efficacy of linked color imaging combined endoscopic dye staining in distinguishing neoplastic from non-neoplastic colorectal tumors,using Pit pattern classification system. Methods A total of 310 colorectal tumors treated in Shenzhen hospital of Southern Medical University from Jan 2017 to Jun 2019 were enrolled in this study.Each lesion was observed by linked color imaging combined endoscopic dye staining and the histology was predicted according to Pit pattern classification system. The results were compared with histologic findings. Results The diagnostic sensitivity,specificity,PPV,NPV and accuracy of Type Ⅰ,Ⅱ and Ⅱ-O were 58. 8%,97. 3%,55. 6%,97. 6% and 95. 2%,respectively. The diagnostic sensitivity,specificity,PPV,NPV and accuracy of Type ⅢL and Ⅳ were 92. 9% 、97. 2% 、94. 3% 、85. 7% and 92. 9%,respectively. The diagnostic sensitivity,specificity,PPV,NPV and accuracy of Type Vi and Vn were 90. 6%,94. 6%,65. 9%,98. 9% and 94. 2%,respectively. The diagnostic sensitivity,specificity,PPV,NPV and accuracy of Type Ⅲs and Vn were 54. 5%,97. 7%,46. 2%,98. 3% and 96. 1%,respectively. Conclusion Linked color imaging using the Pit pattern classification system is an effective method for distinguishing the neoplastic lesions from non-neoplastic colorectal lesions. Further,it is effective to identify the lesions with deeper submucosal invasion.
作者
黄思霖
龚伟
HUANG Si-lin;GONG Wei(Department of Gastroenterology, Shenzhen Hospital, Southern Medical University, Shenzhen 518000)
出处
《现代消化及介入诊疗》
2020年第5期563-567,共5页
Modern Interventional Diagnosis and Treatment in Gastroenterology
基金
国家重点研发计划(2018YFC0115301)
国家自然科学基金(81974070)。
关键词
联动成像技术
化学染色
Pit分型
诊断价值
结直肠肿物
Linked color imaging
Chemical stain
Diagnostic values
Pit pattern classification
Colorectal mass
