窄带成像放大技术可预测结直肠肿瘤的组织学类型和浸润深度。

Narrow-band imaging magnification predicts the histology and invasion depth of colorectal tumors.

作者信息

Kanao Hiroyuki, Tanaka Shinji, Oka Shiro, Hirata Mayuko, Yoshida Shigeto, Chayama Kazuaki

机构信息

Department of Medicine and Molecular Science, Hiroshima University, Hiroshima, Japan.

出版信息

Gastrointest Endosc. 2009 Mar;69(3 Pt 2):631-6. doi: 10.1016/j.gie.2008.08.028.

DOI:10.1016/j.gie.2008.08.028

PMID:19251003

Abstract

BACKGROUND

There are several reports concerning the differential diagnosis of non-neoplastic and neoplastic colorectal lesions by narrow-band imaging (NBI). However, there are only a few NBI articles that assessed invasion depth.

OBJECTIVE

To determine the clinical usefulness of NBI magnification for evaluating microvessel architecture in relation to pit appearances and in the qualitative diagnosis of colorectal tumors.

DESIGN

A retrospective study.

SETTING

Department of Endoscopy, Hiroshima University, Hiroshima, Japan.

PATIENTS AND MAIN OUTCOME MEASUREMENTS

A total of 289 colorectal lesions were analyzed: 12 hyperplasias (HP), 165 tubular adenomas (TA), 65 carcinomas with intramucosal to scanty submucosal invasion (M-SM-s), and 47 carcinomas with massive submucosal invasion (SM-m). Lesions were observed by NBI magnifying endoscopy and were classified according to microvessel features and pit appearances: type A, type B, and type C. Type C was divided into 3 subtypes (C1, C2, and C3), according to the detailed NBI magnifying findings of pit visibility, vessel diameter, irregularity, and distribution. These were compared with histologic findings.

RESULTS

Histologic findings of HP and TA were seen in 80.0% and 20.0%, respectively, of type A lesions. TA and M-SM-s were found in 79.7% and 20.3%, respectively, of type B lesions. TA, M-SM-s, and SM-m were found in 21.6%, 29.9%, and 48.5, respectively, of type C lesions. HPs were observed significantly more often than TAs in type A lesions, TAs were observed significantly more often than carcinomas in type B lesions, carcinomas were observed significantly more often than TAs in type C (P < .01). TA, M-SM-s, and SM-m were found in 46.7%, 42.2%, and 11.1% of type C1 lesions, respectively. M-SM-s and SM-m were found in 45.5% and 54.5%, respectively, of type C2 lesions. SM-m was found in 100% of type C3 lesions. TAs and M-SM-s were observed significantly more often than SM-m in type C1 lesions, and SM-m were observed significantly more often than TAs and M-SM-s in type C3 lesions (P < .01).

CONCLUSIONS

NBI magnification findings of colorectal lesions were associated with histologic grade and invasion depth.

摘要

背景

有几篇关于窄带成像（NBI）鉴别诊断结直肠非肿瘤性和肿瘤性病变的报道。然而，仅有少数NBI文章评估了浸润深度。

目的

确定NBI放大内镜在评估微血管结构与凹陷外观的关系以及结直肠肿瘤定性诊断中的临床应用价值。

设计

一项回顾性研究。

单位

日本广岛市广岛大学内镜科。

患者和主要观察指标

共分析289例结直肠病变：12例增生性病变（HP）、165例管状腺瘤（TA）、65例黏膜内至黏膜下浅层浸润癌（M-SM-s）和47例黏膜下深层浸润癌（SM-m）。通过NBI放大内镜观察病变，并根据微血管特征和凹陷外观进行分类：A型、B型和C型。根据凹陷可见度、血管直径、不规则性和分布的详细NBI放大观察结果，C型分为3个亚型（C1、C2和C3）。将这些结果与组织学结果进行比较。

结果

A型病变中，分别有80.0%和20.0%的病变组织学表现为HP和TA。B型病变中，分别有79.7%和20.3%的病变为TA和M-SM-s。C型病变中，分别有21.6%、29.9%和48.5%的病变为TA、M-SM-s和SM-m。A型病变中HP的观察频率显著高于TA，B型病变中TA的观察频率显著高于癌，C型病变中癌的观察频率显著高于TA（P <.01）。C1型病变中，分别有46.7%、42.2%和11.1%的病变为TA、M-SM-s和SM-m。C2型病变中，分别有45.5%和54.5%的病变为M-SM-s和SM-m。C3型病变中100%为SM-m。C1型病变中TA和M-SM-s的观察频率显著高于SM-m，C3型病变中SM-m的观察频率显著高于TA和M-SM-s（P <.01）。