First Division of Internal Medicine, Service of Gastroenterology and Digestive Endoscopy, Hospital of Busto Arsizio, Busto Arsizio (VA), Italy.
Gastrointest Endosc. 2011 Nov;74(5):1067-74; quiz 1115.e1-5. doi: 10.1016/j.gie.2011.07.022. Epub 2011 Sep 10.
Submucosal malignant masses (SMMs) and innocent bulges look similar on small-bowel capsule endoscopy (SBCE). In a previous observational study, 4 criteria associated with innocent bulges were recognized.
To devise and validate an index based on these criteria (smooth, protruding lesion index on capsule endoscopy [SPICE]) to discriminate SMMs from innocent bulges.
Single-center, prospective study.
General hospital in Busto Arsizio, Italy.
This study involved 25 of 424 consecutive SBCEs performed on as many patients having SBCE findings of smooth, round, protruding lesions.
Patients' evaluation up to the final diagnosis. At study entry, a short video clip of the lesion was obtained and deidentified for blind SPICE calculation.
SPICE accuracy, using the final diagnosis of each patient as the criterion standard.
Six patients had SMMs (4 GI stromal tumors, 2 neuroendocrine tumors), and 19 had innocent bulges. SPICE scores ranged from 0 to 4; they discriminated SMMs from innocent bulges (P = .002). A SPICE value >2 had 83.3% sensitivity and 89.4% specificity, and the area under the curve was 0.90 (95% confidence interval, 0.72-0.98; P < .001) for the detection of SMMs.
Single-center study; small sample size; no invasive ascertainment in 36% of patients.
SPICE is easy to calculate and useful for distinguishing SMMs from innocent bulges. An index >2 is predictive of SMM.
黏膜下恶性肿块（SMM）和良性隆起在小肠胶囊内镜（SBCE）下看起来相似。在之前的一项观察性研究中，发现了与良性隆起相关的 4 个标准。
设计并验证一个基于这些标准的指数（胶囊内镜下黏膜下病变的光滑、突出病变指数 [SPICE]），以区分 SMM 和良性隆起。
单中心、前瞻性研究。
意大利布斯托阿西齐奥的一家综合医院。
本研究纳入了 424 例连续 SBCE 中 25 例，这些患者的 SBCE 检查结果均为光滑、圆形、突出病变。
对患者进行评估直至得出最终诊断。在研究开始时，获取病变的一段短视频片段并进行匿名化处理，以便进行盲法 SPICE 计算。
以每位患者的最终诊断为标准，评估 SPICE 的准确性。
6 例患者存在 SMM（4 例胃肠道间质瘤，2 例神经内分泌肿瘤），19 例为良性隆起。SPICE 评分范围为 0 至 4 分；它们可以区分 SMM 和良性隆起（P =.002）。SPICE 值>2 时，其对 SMM 的敏感性为 83.3%，特异性为 89.4%，曲线下面积为 0.90（95%置信区间，0.72-0.98；P<.001），对 SMM 的检测具有较高的准确性。
单中心研究；样本量小；36%的患者未进行有创性确认。
SPICE 易于计算，可用于区分 SMM 和良性隆起。SPICE 值>2 提示存在 SMM 的可能性。
