Pit pattern analysis by magnifying chromoendoscopy for the diagnosis of colorectal polyps.
Pit pattern analysis by magnifying chromoendoscopy for the diagnosis of colorectal polyps.
复制标题
通过放大色素内镜进行凹坑模式分析以诊断结直肠息肉。
DOI：
10.29828/jfma.200303.0008
复制
发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Jyh
中科院分区：
文献类型：
--
作者：
Hui;S. Kudo;Jyh
背景和目的
放大色素内窥镜的发展促进了对粘膜凹陷模式的观察。本研究探讨该技术在预测大肠病变的组织学表现中的价值。
方法
共有954例结直肠息肉被纳入研究。在结肠镜检查发现病变后，喷洒0.2%吲哚红溶液，然后切换变焦装置，以最大100倍的倍数放大染色的隐窝开口。根据工藤的分类，将观察到的坑型分为6类(I、II、IIIL、IIIS、IV和V)。I型和II型为非肿瘤型，其他为肿瘤型。对切除或活检的息肉进行小窝类型与组织学检查结果的相关性分析。
结果
微小息肉678例(71.1%)，肿瘤性息肉705例(73.9%)，其中腺瘤695例，癌10例。将组织学证实的肿瘤性病变与非肿瘤性病变进行比较，放大染色内窥镜对肿瘤性病变预测的敏感性为90.8%，特异性为72.7%，阳性预测值为90.4%，阴性预测值为73.6%，总体准确率为86.1%。肿瘤性病变的诊断准确率与息肉大小和位置无关，但与操作者的经验有关。
结论
放大色素内窥镜获得的特征性小凹模式为腺瘤性息肉和非腺瘤性息肉的鉴别提供了有用的线索。这项技术在经验丰富的人手中使用得当，在预测大肠息肉的组织学特征方面为标准结肠镜检查提供了一个有价值的辅助工具。
BACKGROUND AND PURPOSE
The development of magnifying chromoendoscopy has facilitated the observation of mucosal pit patterns. This study investigated the value of this technology in predicting the histologic findings of colorectal lesions.
METHODS
A total of 954 colorectal polyps were included. After identifying the lesions at colonoscopy, 0.2% indigocarmine solution was sprayed and then the zoom apparatus was switched to make a magnified view of the stained crypt orifice at a maximum 100 times magnification. The observed pit patterns were classified into 6 categories (I, II, IIIL, IIIS, IV, and V) according to Kudo's classification. Type I and II were designated as non-neoplastic patterns whereas other types were neoplastic. Correlation of the pit pattern with the findings of histologic examinations of resected or biopsied polyps was performed.
RESULTS
There were 678 diminutive (</= 5 mm) polyps (71.1%) and 705 neoplastic polyps (73.9%), including 695 adenomas and 10 carcinomas. When comparing histologically confirmed neoplastic lesions to non-neoplastic lesions, prediction of neoplastic lesions by endoscopists based on magnifying chromoendoscopy had a sensitivity of 90.8%, a specificity of 72.7%, a positive predictive value of 90.4%, a negative predictive value of 73.6%, and an overall accuracy of 86.1%. The diagnostic accuracy for neoplastic lesions was not associated with polyp size and location but was related to the operator's experience.
CONCLUSIONS
Characteristic pit patterns obtained by magnifying chromoendoscopy provide useful clues for differentiation of adenomatous from non-adenomatous polyps. Used appropriately in experienced hands, this technique offers a valuable adjunct to standard colonoscopy in predicting the histologic characteristics of colorectal polyps.