Kanamori Toshinari, Itoh Makoto, Yoshimi Naoki
Endoscopy Unit, Daiyukai Daiichi Hospital, Ichinomiya, Aichi, Japan.
Gastrointest Endosc. 2002 May;55(6):695-700. doi: 10.1067/mge.2002.123620.
Based on 10 years of experience with chromoendoscopy, our hypothesis was that colonic adenomas can be differentiated from hyperplastic polyps by use of a high-pressure spray-jet of dye (pressure dye-spray). To test the accuracy of pressure dye-spray, classification of colonic polyps as adenomas and hyperplastic polyps by pressure dye-spray and ordinary colonoscopic findings (shape, size, and color surface appearance) were compared.
Pressure dye-spray chromoendoscopy was performed by using 0.035% indigo carmine, a spray-type cannula, and a water pump. Polyps were first classified as adenomas or hyperplastic polyps by ordinary colonoscopic findings. One or more pressure dye-spray bursts were then focused on the polyp from a distance of 1 to 2 cm. Polyps were classified as adenomas only if oozing of blood was evident; otherwise, they were classified as hyperplastic polyps. A histologic diagnosis was obtained for all polyps, and the results of ordinary colonoscopic findings and pressure dye-spray were compared.
This study examined 1468 polyps (1201 adenomas, 267 hyperplastic polyps; mean diameter 4 mm). The sensitivities for polyp differentiation with pressure dye-spray and ordinary colonoscopic findings were, respectively, 97.9% and 73.4% (p < 0.0001); specificities were, respectively, 96.6% and 92.1% (p = 0.077).
Pressure dye-spray was found to be a reliable technique for differentiation between adenomas and hyperplastic polyps.
基于10年的色素内镜检查经验，我们的假设是，通过使用高压染料喷雾（压力染料喷雾）可将结肠腺瘤与增生性息肉区分开来。为了测试压力染料喷雾的准确性，比较了通过压力染料喷雾和普通结肠镜检查结果（形状、大小和颜色外观）将结肠息肉分类为腺瘤和增生性息肉的情况。
使用0.035%靛胭脂、喷雾型插管和水泵进行压力染料喷雾色素内镜检查。首先通过普通结肠镜检查结果将息肉分类为腺瘤或增生性息肉。然后从1至2厘米的距离将一个或多个压力染料喷雾脉冲聚焦在息肉上。只有在有明显渗血时息肉才被分类为腺瘤；否则，它们被分类为增生性息肉。对所有息肉进行组织学诊断，并比较普通结肠镜检查结果和压力染料喷雾的结果。
本研究检查了1468个息肉（1201个腺瘤，267个增生性息肉；平均直径4毫米）。压力染料喷雾和普通结肠镜检查结果对息肉鉴别的敏感性分别为97.9%和73.4%（p<0.0001）；特异性分别为96.6%和92.1%（p=0.077）。
发现压力染料喷雾是区分腺瘤和增生性息肉的可靠技术。
