双重对比钡剂检查和内镜检查在大肠小息肉检测中的应用

Double-contrast barium examination and endoscopy in the detection of small polyps of the large intestine.

作者信息

Ahovuo J, Linden H, Kinnunen J, Edgren J, Kellokumpu I, Husa A

机构信息

Fourth Department of Surgery, University Central Hospital, Helsinki, Finland.

出版信息

Ann Chir Gynaecol. 1990;79(3):143-6.

PMID:2264716

Abstract

The purpose of this study was to compare double-contrast barium examination (DCBE) and endoscopy in detection of small colonic polyps. In 57 patients DCBE revealed 106 polyps in the large intestine. On total colonoscopy, 62 polyps could be verified. The size of the polyps excised ranged from 2 to 15 mm. Compared with DCBE, colonoscopy verified 48 true positive, 44 false positive and 14 false negative polyps. In revealing a polyp less than 5 mm, DCBE had a sensitivity of 72%, whereas in detection of larger polyps the sensitivity was 81%. Histological verification was available in 52 of the 62 removed polyps. A tubular adenoma was found in 12 of the 29 diminutive polyps verified with histology. DCBE and colonoscopy could not differentiate between adenomas and hyperplastic polyps. Since a polyp less than 5 mm may represent an adenoma, a precancerous lesion, its removal is indicated during colonoscopy after DCBE has detected it.

摘要

本研究的目的是比较双重对比钡剂检查（DCBE）和内镜检查在检测小的结肠息肉方面的效果。在57例患者中，DCBE发现大肠中有106个息肉。在全结肠镜检查中，可证实62个息肉。切除的息肉大小范围为2至15毫米。与DCBE相比，结肠镜检查证实有48个真阳性、44个假阳性和14个假阴性息肉。在发现小于5毫米的息肉方面，DCBE的敏感性为72%，而在检测较大息肉时，敏感性为81%。62个切除的息肉中有52个获得了组织学证实。在经组织学证实的29个微小息肉中，有12个发现为管状腺瘤。DCBE和结肠镜检查无法区分腺瘤和增生性息肉。由于小于5毫米的息肉可能是腺瘤，即癌前病变，在DCBE检测到后，结肠镜检查时应将其切除。