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目的通过窄带成像放大内镜技术(NBI-ME)对结直肠病变进行观察,研究NBI-ME内镜技术对发现结直肠新生性病变的优势,以及对结直肠肿瘤性病变判断的精准度。方法 680例患者进行了完整普通肠镜、NBI-ME、色素内镜检查。对新生性病变分别用普通光镜、NBI-ME模式及色素放大方法观察病变表面结构,记录微血管形态(MP)和腺管开口分型(pit),对病变性质的判断结果与病理诊断比较。结果 NBI-ME在385例患者发现新生性病变513个,而普通光镜只检出其中的74.1%(380/513),有显著统计学差异(P<0.01)。色素内镜能检出86.0%(441/513),也有显著统计学差异(P<0.05)。普通光镜漏检主要为微小病变及平坦型病变。NBI-ME对判断病变肿瘤性或非肿瘤性准确率为94.2%,敏感性90.2%,特异性95.3%,显著高于普通光镜和色素内镜(P<0.001)。结论 NBI-ME内镜技术有利于发现微小病变和平坦型病变,能清晰观察病变表面pit形态结构、微血管形态,对判断病变肿瘤性或非肿瘤的准确率明显比普通内镜和色素内镜高,检查操作时转换模式方便,NBI-ME将成为发现结直肠新生性病变和鉴别是否肿瘤性的更有效的内镜检查方法。
Objective To observe the advantages and disadvantages of NBI-ME endoscopy in the detection of colorectal neoplasms and the accuracy of colorectal neoplasms by narrow-band imaging magnifying endoscopy (NBI-ME). Methods A total of 680 patients underwent general colonoscopy, NBI-ME and chromoendoscopy. Pathological changes of the nasal lesions were observed by ordinary light microscope, NBI-ME mode and pigmentation magnification method, respectively. Microvascular morphology (MP) and pit opening were recorded. The pathological findings were compared with pathological findings. Results There were 513 neonate lesions in 385 patients with NBI-ME, while only 74.1% (380/513) were detected in common light microscope with significant difference (P <0.01). Pigment endoscopy can detect 86.0% (441/513), there are significant statistical differences (P <0.05). Ordinary light missed inspection mainly minor lesions and flat lesions. The diagnostic accuracy of NBI-ME was 94.2%, the sensitivity was 90.2% and the specificity was 95.3%. The accuracy of NBI-ME was significantly higher than that of common light and endoscopy (P <0.001). Conclusion NBI-ME endoscopy is helpful to detect minimal and flat lesions, and to clearly observe the morphology and microvascular morphology of pit on the surface of lesions. The accuracy of NBI-ME in judging the neoplastic or non-neoplastic lesions was significantly higher than that of common endoscopy and endoscopic ultrasonography , The convenient mode of operation for the examination of the procedure, the NBI-ME will be a more effective endoscopy for the detection of colorectal neoplasia and the identification of neoplastic disease.