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目的通过窄带成像放大内镜技术(NBI-ME)对结直肠病变表面微血管形态进行观察分型,研究NBI-ME对检出早期结直肠肿瘤性病变的价值。方法肠镜检查发现新生性病变后,用NBI-ME模式观察病变表面微血管形态并进行分型,所有病变均在内镜下切除或手术切除,将NBI-ME判断病变的性质与病理诊断结果比较。结果 NBI-ME在2115例患者中发现新生性病变2778个,MP-0型诊断为炎性息肉的准确率为97.4%,MP-Ⅰ型诊断为增生性息肉的准确率为93.3%,MP-Ⅱ型诊断为管状腺瘤准确率为97.2%,MP-Ⅲ型诊断为绒毛状腺瘤准确率为98.3%,MP-Ⅳ型诊断为绒毛状-管状腺瘤准确率为94.5%,MP-Ⅴ型诊断为高级别上皮内瘤变准确率为96.9%,MP-Ⅵ型诊断为黏膜内癌准确率为90.9%,MP-Ⅶ型诊断为浸润癌准确率为88.0%,MP-Ⅷ型诊断为进展期癌准确率为100.0%。NBI-ME对病变表面微血管形态判断肿瘤性病变的准确性为98.8%,敏感度为99.2%,特异性为94.9%。结论 NBI-ME内镜技术病变表面微血管形态分型,对判断病变是否是肿瘤性病变的准确率高,对早期结直肠肿瘤或结直肠癌的病理诊断预测准确率高,NBI-ME将成为发现结直肠早期肿瘤的更有效的内镜检查方法。
Objective To evaluate the value of NBI-ME in the detection of colorectal neoplasms by narrowband imaging magnifying endoscopy (NBI-ME). Methods After the pathological changes of neoplasms were observed by enteroscopy, the morphological changes of microvessels were observed by NBI-ME and all the lesions were removed by endoscopy or surgical resection. The pathological features of NBI-ME were compared with the pathological findings . Results In NBI-ME, 2778 newborn lesions were found in 2115 cases. The accuracy rate of MP-0 diagnosis of inflammatory polyps was 97.4%. The accuracy of MP-Ⅰ diagnosis of proliferative polyps was 93.3% The accuracy of type Ⅱ diagnosis of tubular adenoma was 97.2%, the accuracy of MP-Ⅲ type diagnosis of villous adenoma was 98.3%, MP-Ⅳ type diagnosis of villous tubular adenoma was 94.5%, MP-Ⅴ Type diagnosis of high-grade intraepithelial neoplasia was 96.9% accuracy, MP-Ⅵ diagnosis of intramucosal cancer was 90.9% accuracy, MP-Ⅶ diagnosis of invasive carcinoma was 88.0% accuracy, MP-Ⅷ type diagnosis was The accuracy rate of advanced cancer was 100.0%. The accuracy of NBI-ME for the determination of neoplastic lesions on the surface of the lesion was 98.8%, with a sensitivity of 99.2% and a specificity of 94.9%. Conclusion NBI-ME endoscopic microvascular morphological classification of lesions on the surface of the lesion is to determine whether the high accuracy of the pathological diagnosis of early colorectal cancer or colorectal cancer pathological diagnosis prediction accuracy, NBI-ME will be found More effective endoscopy for colorectal tumors.