A prospective comparative study of narrow-band imaging, chromoendoscopy, and conventional colonoscopy in the diagnosis of colorectal neoplasia
A prospective comparative study of narrow-band imaging, chromoendoscopy, and conventional colonoscopy in the diagnosis of colorectal neoplasia
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DOI：
10.1136/gut.2006.099614
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发表时间：
2007-03-01
期刊：
影响因子：
24.5
通讯作者：
Wang, Hsiu-Po
中科院分区：
文献类型：
--
作者：
Chiu, Han-Mo;Chang, Chi-Yang;Wang, Hsiu-Po
背景：区分肿瘤和非肿瘤病变在结直肠癌筛查中至关重要。窄带成像（NBI）在结肠镜检查中的应用可以显示肿瘤病变的粘膜血管网络，并可能提高诊断的准确性。目的：比较NBI在鉴别结直肠肿瘤与非肿瘤病变中的诊断效果与标准方式、常规结肠镜检查和彩色内镜检查的诊断效果。方法：在这项前瞻性研究中，对133例患者的180例结直肠病变进行了常规结肠镜检查，并在低、高倍NBI和彩色内镜下进行了观察。切除病变进行组织病理学分析。内窥镜图像以电子方式存储，并随机分配给两个阅读器进行评估。结合组织病理学对每种内镜方式的敏感性、特异性和诊断准确性进行评估。结果：与常规结肠镜检查相比，NBI和彩色内镜在高倍镜下评分高于低倍镜下评分。低、高倍镜下NBI的诊断准确率均显著高于常规结肠镜检查（低倍镜：读写器1 p = 0.0434，读写器2 p = 0.004；高倍镜：两种读写器p < 0.001），与色内窥镜检查相当。结论：低倍和高倍NBI均能区分结直肠肿瘤与非肿瘤病变；NBI的诊断准确率优于常规结肠镜检查，与色镜检查相当。NBI在结肠镜筛查中的作用有待进一步评估。
Background: Discrimination between neoplastic and non-neoplastic lesions is crucial in colorectal cancer screening. Application of narrow-band imaging (NBI) in colonoscopy visualises mucosal vascular networks in neoplastic lesions and may improve diagnostic accuracy. Aim: To compare the diagnostic efficacy of NBI in differentiating neoplastic from non-neoplastic colorectal lesions with diagnostic efficacies of standard modalities, conventional colonoscopy, and chromoendoscopy.Methods: In this prospective study, 180 colorectal lesions from 133 patients were observed with conventional colonoscopy, and under low-magnification and high-magnification NBI and chromoendoscopy. Lesions were resected for histopathological analysis. Endoscopic images were stored electronically and randomly allocated to two readers for evaluation. Sensitivity, specificity and diagnostic accuracy of each endoscopic modality were assessed by reference to histopathology.Results: NBI and chromoendoscopy scored better under high magnification than under low magnification in comparison with conventional colonoscopy. The diagnostic accuracy of NBI with low or high magnification was significantly higher than that of conventional colonoscopy ( low magnification: p = 0.0434 for reader 1 and p = 0.004 for reader 2; high magnification: p < 0.001 for both readers) and was comparable to that of chromoendoscopy.Conclusion: Both low-magnification and high-magnification NBI were capable of distinguishing neoplastic from non-neoplastic colorectal lesions; the diagnostic accuracy of NBI was better than that of conventional colonoscopy and equivalent to that of chromoendoscopy. The role of NBI in screening colonoscopy needs further evaluation.