Iwatate Mineo, Ikumoto Taro, Hattori Santa, Sano Wataru, Sano Yasushi, Fujimori Takahiro
Gastrointestinal Center, Sano Hospital, Kobe 655-0031, Japan.
Diagn Ther Endosc. 2012;2012:173269. doi: 10.1155/2012/173269. Epub 2012 Dec 9.
Although magnifying chromoendoscopy had been a reliable diagnostic tool, narrow-band imaging (NBI) has been developed in Japan since 1999 and has now replaced the major role of chromoendoscopy because of its convenience and simplicity. In this paper, we principally describe the efficacy of magnifying chromoendoscopy and magnifying colonoscopy with NBI for detection, histological prediction, estimation of the depth of early colorectal cancer, and future prospects. Although some meta-analyses have concluded that NBI is not superior to white light imaging for detection of adenomatous polyps in screening colonoscopy, NBI with magnification colonoscopy is useful for histological prediction, or for estimating the depth of invasion. To standardize these diagnostic strategies, we will focus on the NBI International Colorectal Endoscopic (NICE) classification proposed for use by endoscopists with or without a magnifying endoscope. However, more prospective research is needed to prove that this classification can be applied with satisfactory availability, feasibility, and reliability. In the future, NBI might contribute to the evaluation of real-time histological prediction during colonoscopy, which has substantial benefits for both reducing the risk of polypectomy and saving the cost of histological evaluation by resecting and discarding diminutive adenomatous polyps (resect and discard strategy).
尽管放大色素内镜曾是一种可靠的诊断工具，但窄带成像（NBI）自1999年起在日本得到发展，如今因其便捷性和简易性已取代了色素内镜的主要作用。在本文中，我们主要描述放大色素内镜以及NBI放大结肠镜在早期结直肠癌检测、组织学预测、浸润深度评估方面的效能及未来前景。尽管一些荟萃分析得出结论，在筛查结肠镜检查中，NBI在检测腺瘤性息肉方面并不优于白光成像，但NBI放大结肠镜对于组织学预测或浸润深度评估是有用的。为使这些诊断策略标准化，我们将重点关注为有或没有放大内镜的内镜医师使用而提出的NBI国际结直肠内镜（NICE）分类。然而，需要更多前瞻性研究来证明这种分类能够以令人满意的可用性、可行性和可靠性来应用。未来，NBI可能有助于结肠镜检查期间实时组织学预测的评估，这对于降低息肉切除风险以及通过切除并丢弃微小腺瘤性息肉（切除并丢弃策略）节省组织学评估成本都有很大益处。
