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目的探讨窄带成像结肠镜(NBI)诊断结直肠息肉样病变的临床价值。方法于2014年1月—2015年12月结肠镜中心发现198例结直肠息肉样变,应用窄带成像结肠镜、常规白光内镜分别检查黏膜表面的腺管开口与血管形态,结果再与病理组织学检查进行对比。结果在198例患者中发现结直肠息肉样病变有257个,NBI内镜与常规白光内镜在黏膜表面分型的腺管开口的差异有统计学意义(P<0.05),NBI内镜明显优于白光内镜;NBI Kudo和佐野宁内镜对结直肠肿瘤性病变诊断的特异性、敏感性、符合率分别为:87.77%、91.52%、89.49%;89.20%、88.98%、89.11%,与白光内镜在特异性和符合率的差异有统计学意义(χ~(2a)=7.7887,Pa=0.005,χ~(2a)=5.5619,Pa=0.018;χ~(2b)=9.5149,Pa=0.002,χ~(2a)=5.1807,Pa=0.023);但三种检查方法的敏感性差异却无统计学意义(χ~2=2.4361,P=0.304)。与病理组织学检查相参照,NBI内镜明显优于常规内镜。结论 NBI内镜可以更加清晰显像结直肠息肉样病变的黏膜表明腺管开口以及微血管形态,可以更好地鉴别和诊断结直肠肿瘤,具有比较高的临床价值。
Objective To investigate the clinical value of narrow-band imaging colonoscopy (NBI) in the diagnosis of colorectal polypoid lesions. Methods From January 2014 to December 2015, 198 cases of colorectal polyps were found in the colonoscopy center. Narrowband imaging colonoscopy and routine white light endoscopy were used to examine the mucosal surface of the duct opening and vascular morphology. The results were compared with the pathological tissues School exams for comparison. Results Among the 198 patients, there were 257 colorectal polypoid lesions. There was significant difference between NBI endoscopy and conventional white endoscopy in the classification of mucosal surface (P <0.05), and NBI endoscopy was significantly better In white light endoscopy, the specificity and sensitivity of NBI Kudo and Sano Nien endoscopy in the diagnosis of colorectal neoplasia were 87.77%, 91.52%, 89.49%, 89.20%, 88.98%, 89.11%, respectively The difference of specificity and coincidence rate of white endoscopy was statistically significant (χ ~ (2a) = 7.7887, Pa = 0.005, χ2a = 5.5619, Pa = 0.018, χ2b = 9.5149, Pa = 0.002, χ2a = 5.1807, Pa = 0.023). However, there was no significant difference in the sensitivity of the three methods (χ ~ 2 = 2.4361, P = 0.304). Compared with histopathological examination, NBI endoscopic significantly better than conventional endoscopy. Conclusion NBI endoscopy can be more clearly visualized polypoid lesions of colorectal mucosa that duct openings and microvascular morphology, can better identify and diagnose colorectal tumors with high clinical value.