Diagnosis of colorectal tumorous lesions by magnifying endoscopy
Diagnosis of colorectal tumorous lesions by magnifying endoscopy
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DOI：
10.1016/s0016-5107(96)70222-5
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发表时间：
1996-07-01
影响因子：
7.7
通讯作者：
Watanabe, H
中科院分区：
文献类型：
--
作者：
Kudo, SE;Tamura, S;Watanabe, H
背景：放大结肠镜可以将结肠表面放大100倍。方法：我们通过放大内镜、立体显微镜和组织病理学检查了2050个结直肠肿瘤病灶，并根据凹坑模式对这些病灶进行分类。根据立体显微镜，具有1型或2型凹坑图案的病变为非肿瘤，而具有3s、3L、4和/或5型凹坑图案的病变为肿瘤性肿瘤。结果：放大内镜观察到的凹坑图案与立体显微镜图像显示的基本相似。当放大内窥镜诊断与立体显微镜诊断进行比较时，1387个病变中有1130个（81.5%）一致。真正的肿瘤可以与非肿瘤性病变区分开来。在具有边界表面的 5 型凹坑图案的病变中，22 个中的 11 个 (50%) 被发现是累及粘膜下层的侵袭性癌症。如果发现这种凹坑模式涉及粘膜表面相对较广的区域，则应强烈怀疑广泛的恶性侵犯（sm-massive）。结论：放大结肠镜可以准确地即时评估结直肠肿瘤病变的组织学。这可能有助于结肠镜检查期间的决策。
Background: The magnifying colonoscope allows 100-fold magnified viewing of the colonic surface.Methods: We examined 2050 colorectal tumorous lesions by magnifying endoscopy, stereomicroscopy, and histopathology and classified these lesions according to pit pattern. Based on stereomicroscopy, lesions with a type 1 or 2 pit pattern were nontumors, whereas lesions with types 3s, 3L, 4, and/or 5 pit patterns were neoplastic tumors.Results: The pit patterns observed by magnifying endoscopy were fundamentally similar to those demonstrated in stereomicroscopic images. When the diagnosis by magnifying endoscopy was compared with the stereomicroscopic diagnosis, there was agreement in 1130 of 1387 lesions (81.5%). True neoplasms could be differentiated from non-neoplastic lesions. Of lesions with a type 5 pit pattern with a bounded surface, 11 of 22 (50%) were found to be invasive cancers with involvement of the submucosal layer. If this pit pattern is found to involve a relatively broad area of the mucosal surface, extensive malignant invasion (sm-massive) should be strongly suspected.Conclusions:The magnifying colonoscope provides an accurate instantaneous assessment of the histology of colorectal tumorous lesions. This may help in decision making during colonoscopy.