计算机化虚拟 chromoendoscopy 与靛胭脂 chromoendoscopy 联合放大对小结直肠病变的诊断：一项随机前瞻性研究。

Computerized virtual chromoendoscopy versus indigo carmine chromoendoscopy combined with magnification for diagnosis of small colorectal lesions: a randomized and prospective study.

机构信息

Department of Gastroenterology and Pathology, Santa Casa Hospital, Bagé, Brazil.

出版信息

Eur J Gastroenterol Hepatol. 2010 Nov;22(11):1364-71. doi: 10.1097/MEG.0b013e32833a5d63.

DOI:10.1097/MEG.0b013e32833a5d63

PMID:20453654

Abstract

BACKGROUND AND STUDY AIMS

Magnifying colonoscopy with indigo carmine dye and the analysis of the capillary and the pit patterns by computed virtual chromoendoscopy (Fujinon Intelligent Color Enhancement, FICE) with magnification are effective for the differential diagnosis of neoplastic and non-neoplastic lesions. This study aimed to compare the accuracy of virtual and real chromoendoscopy in differentiating neoplastic and non-neoplastic colorectal lesions.

PATIENTS AND METHODS

A prospective randomized trial of magnification colonoscopy with targeted FICE (Group I - 72 patients/111 lesions) versus magnification colonoscopy with targeted indigo carmine dye (Group II - 72 patients/137 lesions) was performed in consecutive patients with lesions 1 cm or less. Histopathology of the specimens was regarded as the gold standard.

RESULTS

In group I, 86 (77.5%) lesions showed an intense vascular pattern (positive capillary meshwork), of which 80 (93%) were histologically confirmed as adenomas. From 25 lesions with negative capillary meshwork, 23 (92%) were non-neoplastic. Sensitivity, specificity, accuracy, positive and negative predictive values of the capillary meshwork for the differential diagnosis of these lesions was 97.8, 79.3, 92.8, 93 and 92%, respectively. The same parameters for pit pattern analysis by FICE were 92.7, 82.3, 90.1, 93.8 and 80%, respectively. Indigo carmine magnified chromoscopy showed sensitivity, specificity, accuracy, positive and negative predictive values of 97, 88.9, 94.9, 96.1 and 91.4%, respectively in the discrimination between neoplastic and non-neoplastic lesions.

CONCLUSION

Magnified virtual chromoendoscopy is as accurate as indigo carmine magnified chromoendoscopy in distinguishing between neoplastic from non-neoplastic small colorectal lesions.

摘要

背景和研究目的

靛胭脂放大染色结合虚拟分光比色技术（FICE）下的毛细血管和pit 模式分析对鉴别肿瘤性和非肿瘤性病变具有重要意义。本研究旨在比较虚拟和真实分光比色技术在鉴别结直肠肿瘤性和非肿瘤性病变中的准确性。

患者和方法

前瞻性随机试验纳入了直径 1cm 及以下病变的患者，分为两组：接受靶向 FICE 放大染色的结肠镜检查（I 组，72 例/111 个病灶）和接受靶向靛胭脂放大染色的结肠镜检查（II 组，72 例/137 个病灶）。以组织病理学结果为金标准。

结果

在 I 组中，86 个（77.5%）病灶显示明显的血管模式（阳性毛细血管网），其中 80 个（93%）经组织学证实为腺瘤。25 个阴性毛细血管网病灶中，23 个（92%）为非肿瘤性。毛细血管网在这些病变中的鉴别诊断中，灵敏度、特异度、准确性、阳性预测值和阴性预测值分别为 97.8%、79.3%、92.8%、93%和 92%。FICE 下 pit 模式分析的相同参数分别为 92.7%、82.3%、90.1%、93.8%和 80%。靛胭脂放大染色的结肠镜检查在鉴别肿瘤性和非肿瘤性病变时，灵敏度、特异度、准确性、阳性预测值和阴性预测值分别为 97%、88.9%、94.9%、96.1%和 91.4%。