Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Asahi-machi 67, Kurume 830-0011, Japan.
Oncol Rep. 2011 Jul;26(1):43-8. doi: 10.3892/or.2011.1287. Epub 2011 Apr 28.
A newly developed autofluorescence (AF) imaging technique was applied during colonoscopy in a clinical setting. This pilot study was conducted to evaluate the clinical feasibility of applying AF endoscopy for distinguishing colorectal lesions. A total of 54 colorectal mucosal lesions obtained from 43 patients who underwent both white-light and AF endoscopy and were treated by endoscopy or surgery were assessed. Of the lesions, 11 were hyperplastic polyps, 30 were adenomas and 13 were carcinomas. To quantify the AF intensity, a color-contrast index (CCI) was determined and evaluated in relation to the histology, size and shape of each lesion. CCI was significantly associated with the histology and size of the lesions, but not their shape. CCI increased as the malignant potential increased (in the order of hyperplastic polyps→adenomas→carcinomas), irrespective of the lesion size (r=0.797, p<0.0001 for size>8 mm; r=0.622, p=0.0045 for size>8 mm but >15 mm; r=0.644, p=0.0071 for size>15 mm). In each size group, CCI tended to be higher for carcinomas than for adenomas, and also higher for adenomas than for hyperplastic polyps. CCI allowed discrimination of adenomas/carcinomas from hyperplastic polyps with 95.3% sensitivity and 63.6% specificity (cut-off value, 14.5), and of colorectal carcinomas from adenomas with 84.6% sensitivity and 80.0% specificity (cut-off value, 28.0). These results suggest that the quantitative analysis of AF intensity using CCI is helpful to discriminate among different types of colorectal mucosal lesions, including carcinomas.
一种新开发的自动荧光（AF）成像技术已在临床结肠镜检查中应用。本研究旨在评估应用 AF 内镜区分结直肠病变的临床可行性。共评估了 43 例患者的 54 个白光和 AF 内镜下获得的结直肠黏膜病变，这些病变经内镜或手术治疗。病变中，增生性息肉 11 个，腺瘤 30 个，癌 13 个。为了量化 AF 强度，确定了颜色对比指数（CCI），并评估了每个病变的组织学、大小和形状。CCI 与病变的组织学和大小显著相关，但与形状无关。随着恶性潜能的增加，CCI 增加（增生性息肉→腺瘤→癌），与病变大小无关（r=0.797，p<0.0001，病变大小>8mm；r=0.622，p=0.0045，病变大小>8mm 但>15mm；r=0.644，p=0.0071，病变大小>15mm）。在每个大小组中，癌的 CCI 倾向于高于腺瘤，腺瘤的 CCI 也高于增生性息肉。CCI 可以将腺瘤/癌与增生性息肉区分开来，敏感性为 95.3%，特异性为 63.6%（截断值为 14.5），将结直肠癌与腺瘤区分开来，敏感性为 84.6%，特异性为 80.0%（截断值为 28.0）。这些结果表明，使用 CCI 对 AF 强度进行定量分析有助于区分不同类型的结直肠黏膜病变，包括癌。
