Comparison of the diagnostic performance between magnifying chromoendoscopy and magnifying narrow-band imaging for superficial colorectal neoplasms: an online survey
Comparison of the diagnostic performance between magnifying chromoendoscopy and magnifying narrow-band imaging for superficial colorectal neoplasms: an online survey
复制标题
DOI：
10.1016/j.gie.2017.12.021
复制
发表时间：
2018-05-01
影响因子：
7.7
通讯作者：
Saito, Yutaka
中科院分区：
文献类型：
--
作者：
Sakamoto, Taku;Nakajima, Takeshi;Saito, Yutaka
背景和目标：放大窄带成像（mag-NBI）和放大色素内镜使用结晶紫染色进行小凹模式分析（小凹模式）是诊断浅表结直肠肿瘤浸润深度的高度准确性。然而，NBI和小坑模式还没有compared.Methods：我们进行了一项在线调查的内窥镜医师感兴趣的图像增强内镜。使用白色光、mag-NBI和凹坑图案的静止图像收集自日本东京国立癌症中心医院（NCCH）诊断的病变。本次调查招募了60名来自NCCH以外的内镜医师，他们通常使用放大内镜。我们评估的诊断准确性使用受试者工作特征（ROC）分析的基础上计算的ROC curve.Results下的面积：100早期结直肠肿瘤被选中进行这项调查。组织学检查显示，尽管67个病变具有高度异型增生或癌伴浅表粘膜下浸润（SM-s），但其他33个病变具有癌伴深层粘膜下浸润（SM-d）。MAG-NBI的ROC曲线下面积与小凹模式的ROC曲线下面积相比，后者对深度侵犯的诊断准确性明显更高（mag-NBI为0.83 [95%CI，0.81-0.85]，小窝模式为0.88 [95%CI，0.85-0.89]，P = 0.013）。在诊断肿瘤浸润深度时，以小凹型为首选，而mag-NBI为最可靠的方法。
Background and Aims: Magnifying narrow-band imaging (mag-NBI) and magnifying chromoendoscopy using crystal violet staining for pit pattern analysis (pit pattern) is highly accurate for diagnosing invasion depth of superficial colorectal neoplasms. However, NBI and pit pattern have not been compared.Methods: We conducted an online survey of endoscopists interested in image-enhanced endoscopy. Still images using white light, mag-NBI, and pit pattern were collected from lesions diagnosed at the National Cancer Center Hospital (NCCH), Tokyo, Japan. Sixty endoscopists from outside NCCH who typically use magnifying endoscopy were recruited for this survey. We assessed the diagnostic accuracy using receiver operating characteristic (ROC) analysis based on a calculation of the area under the ROC curve.Results: One hundred early colorectal neoplasms were selected for this survey. Histopathology revealed that, although 67 of the lesions had high-grade dysplasia or carcinoma with superficial submucosal (SM-s) invasion, the other 33 lesions had a carcinoma with deep submucosal invasion (SM-d). Comparing the area under the ROC curve from mag-NBI with that of pit pattern, the latter showed significantly higher diagnostic accuracy for depth invasion (0.83 [95% CI, 0.81-0.85] for mag-NBI, 0.88 [95% CI, 0.85-0.89] for pit pattern, P = .013).Conclusions: Pit pattern should be the first choice for diagnosing invasion depth as the most reliable modality rather than mag-NBI.