McCallum Audrey L, Jenkins John T, Gillen Derek, Molloy Richard G
Department of Surgical Gastroenterology, Gartnavel General Hospital, Glasgow, Scotland.
Gastrointest Endosc. 2008 Aug;68(2):283-90. doi: 10.1016/j.gie.2007.10.039. Epub 2008 Mar 10.
Colorectal cancer is the second most common cause of death in the United Kingdom. Most cancers are believed to arise within preexisting adenomas. Although colorectal adenomas have a clear neoplastic potential, hyperplastic polyps do not. It, therefore, would be helpful to be able to differentiate between different polyps at a colonoscopy. Autofluorescence (AF) endoscopy has been developed to enhance conventional white light (WL) endoscopy in the diagnosis of GI lesions.
The aim of the present study was to evaluate whether AF colonoscopy can facilitate endoscopic detection and differentiation of colorectal polyps.
Patients were invited to attend for colonic assessment with both AF and WL endoscopy. AF readings, pictures, and biopsy specimens were taken of any visible pathology and of any high AF areas.
Gartnavel General Hospital, Glasgow, U.K.
A total of 107 patients were assessed.
Each patient was assessed with AF and WL colonoscopy.
An AF intensity ratio (AIR) was calculated for each polyp (ratio of direct polyp AF reading/background rectal AF activity).
A total of 75 polyps were detected: 54 adenomatous and 21 hyperplastic polyps. Colorectal adenomas had a significantly higher AIR compared with hyperplastic polyps (median, interquartile range): adenoma (3.54, 2.54-5.00] versus hyperplastic (1.60, 1.30-2.24); P = .0001). When using an AIR with the empirically cutoff value of 2.3, AF endoscopy had a sensitivity of 85% and a specificity of 81% at distinguishing adenomatous polyps from hyperplastic polyps.
AF colonoscopy may be a valuable tool for the visual distinction between adenomatous and hyperplastic polyps.
在英国，结直肠癌是第二大常见死因。大多数癌症被认为起源于先前存在的腺瘤。尽管结直肠腺瘤具有明确的肿瘤发生潜能，但增生性息肉则不然。因此，在结肠镜检查时能够区分不同类型的息肉将很有帮助。自体荧光（AF）内镜已被开发出来，以增强传统白光（WL）内镜在胃肠道病变诊断中的作用。
本研究的目的是评估AF结肠镜检查是否有助于内镜下检测和区分结直肠息肉。
邀请患者接受AF和WL结肠镜检查以进行结肠评估。对任何可见病变和任何高AF区域进行AF读数、拍照及活检取材。
英国格拉斯哥的加特内韦尔综合医院
共评估了107例患者。
每位患者均接受AF和WL结肠镜检查。
计算每个息肉的AF强度比（AIR）（息肉直接AF读数/直肠背景AF活性之比）。
共检测到75个息肉：54个腺瘤性息肉和21个增生性息肉。结直肠腺瘤的AIR显著高于增生性息肉（中位数，四分位间距）：腺瘤（3.54，2.54 - 5.00] 对比增生性息肉（1.60，1.30 - 2.24）；P = .0001）。当使用经验性截断值为2.3的AIR时，AF内镜在区分腺瘤性息肉和增生性息肉方面的敏感性为85%，特异性为81%。
AF结肠镜检查可能是在视觉上区分腺瘤性息肉和增生性息肉的一种有价值的工具。
