Quantitative analysis of the color change after iodine staining for diagnosing esophageal high-grade intraepithelial neoplasia and invasive cancer
Quantitative analysis of the color change after iodine staining for diagnosing esophageal high-grade intraepithelial neoplasia and invasive cancer
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DOI：
10.1016/j.gie.2008.04.052
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发表时间：
2009-02-01
影响因子：
7.7
通讯作者：
Ishiguro, Shingo
中科院分区：
文献类型：
--
作者：
Ishihara, Ryu;Yamada, Takuya;Ishiguro, Shingo
背景资料：尽管其检测食管癌的高灵敏度，碘染色的色素内镜具有低特异性，需要许多活检标本，这是不可取的。碘染色后颜色显著变化（最初为白黄色，2 - 3分钟后变为粉红色）已被认为是癌性病变中的粉红色体征。目的：本研究的目的是通过定量分析验证粉红色体征诊断食管鳞状细胞肿瘤的准确性。设计：通过前瞻性汇总数据对内镜图像进行定量分析。设置：癌症转诊中心。患者：从2003年12月到2005年9月，前瞻性招募了连续患者，这些患者接受了经验丰富的内窥镜医生的手术，并且有直径5至20 mm的碘未染色病变，没有明显的突起或溃疡。主要结果测量：碘染色后2分钟颜色变化定量评价的诊断能力（晚期）通过使用接收器操作特征分析进行了研究。32例患者的45个碘未染色病变包括在该研究中，23个粉红色阳性病变中有22个被诊断为高级别上皮内瘤变或浸润性癌，而22个粉红色阴性病变中有19个被诊断为非肿瘤性病变或低级别上皮内瘤变。受试者工作特征曲线下的面积为0.94，表明该测试具有良好的效度。敏感性为88%，特异性为95%。局限性：单中心回顾性分析。结论：通过定量分析，证实了粉红色征诊断食管鳞癌的准确性。（Gastrointest Endosc 2009;69：213-8.）
Background: Despite its high sensitivity for detecting esophageal cancer, chromoendoscopy with iodine staining has low specificity and requires many biopsy specimens, which is undesirable. Dramatic color change after Iodine staining (initially whitish yellow and then pink 2 to 3 minutes later) has come to be recognized as the pink-color sign in cancerous lesions.Objective: The aim of the present Study was to verify the accuracy of the pink-color sign for diagnosing esophageal squamous neoplasms by a quantitative analysis.Design: A quantitative analysis of endoscopic images was performed by using prospectively pooled data.Setting: A cancer referral center.Patients: From December 2003 to September 2005, consecutive patients who underwent a procedure by an experienced endoscopist and had iodine-unstained lesions measuring 5 to 20 mm in diameter without obvious protrusions or ulcers were prospectively enrolled.Main Outcome Measurements: The diagnostic ability of the quantitative assessment of the color change at 2 Minutes after iodine staining (late phase) was investigated by using a receiver operating characteristic analysis.Results: A total of 45 iodine-unstained lesions in 32 patients were included in the study Among these, 22 of 23 pink-color-positive lesions were diagnosed as high-grade intraepithelial neoplasias or invasive cancers, whereas 19 of 22 pink-color-negative lesions were diagnosed as nonneoplastic lesions or low-grade intraepithelial neoplasias. The area under the receiver operating characteristic Curve was 0.94, indicating excellent validity of the test. A sensitivity of 88% and specificity of 95% were obtained.Limitations: Single-center retrospective analysis. Conclusions: We verified the accuracy Of the pink-color sign for diagnosing esophageal squamous neoplasms by,I quantitative analysis. (Gastrointest Endosc 2009;69:213-8.)