Chromoendoscopy for detection of proximal serrated lesions in routine screening colonoscopy.
Chromoendoscopy for detection of proximal serrated lesions in routine screening colonoscopy.
复制标题
色素内窥镜检查用于在常规筛查结肠镜检查中检测近端锯齿状病变。
DOI：
10.1016/s2468-1253(19)30079-2
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
A. Buchner
中科院分区：
文献类型：
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作者：
A. Buchner
在接受筛查性结肠镜检查的平均风险患者中，近端锯齿状病变的患病率估计高于以前的报道。结直肠癌不仅可以通过腺癌序列发展，还可以通过锯齿状途径发展，近端锯齿状瘤变增加，可能占病例的20%。2.位于右半结肠的锯齿状病变的外观非常微妙，特别容易被忽视。结肠镜检查作为一种筛查方式可以忽略这些病变，这可以解释筛查结肠镜检查没有显著减少右侧结肠癌。因此，充分识别和检测此类病变至关重要。对比增强内镜技术的进步旨在提高结肠镜检查中发现任何异型增生病变（包括锯齿状近端结肠病变）的能力，染料染色内镜是最早的图像增强技术之一，旨在帮助可视化细微病变，并在内镜切除这些病变之前确定表面染色模式。此外，在过去的10年中，新的高清晰度结肠镜系统提供虚拟色素内镜（例如，窄带成像[NBI]，i-scan和灵活的光谱成像彩色增强）已被引入，虚拟色素内镜在改善异型增生检测和近端锯齿状病变表征中的作用得到了进一步研究。3
The prevalence of proximal serrated lesions in averagerisk patients undergoing screening colonoscopy is estimated to be higher than previously reported. 1 Colorectal cancer can develop not only via the adenomacarcinoma sequence, but also via a serrated pathway, with an increase in proximal serrated neoplasia, which could account for up to 20% of cases. 2 Serrated lesions localised in the right colon have very subtle appearances and are especially easy to miss. Colonoscopy as a screening modality can overlook these lesions, which could explain the absence of a significant reduction in colon cancer originating on the right side with screening colonoscopy. Thus, adequate recognition and detection of such lesions is crucial. Advances in contrast-enhanced endoscopic techniques have aimed to improve the ability to detect any dysplastic lesions, including serrated proximal colon lesions, during colonoscopy exams.Chromoendoscopy with dye staining represents one of the earliest image-enhanced techniques aimed at helping to visualise subtle lesions and to define surface staining patterns before endoscopic resections of those lesions. In addition, over the past 10 years new high-definition colonoscopy systems offering virtual chromoendoscopy (eg, as narrow band imaging [NBI], i-scan, and flexible spectral imaging colour enhancement) have been introduced, and the role of virtual chromoendoscopy in improvement of dysplasia detection and characterisation of proximal serrated lesions further investigated. 3