Fujiya Mikihiro, Kashima Shin, Ikuta Katsuya, Dokoshi Tatsuya, Sakatani Aki, Tanaka Kazuyuki, Ando Katsuyoshi, Ueno Nobuhiro, Tominaga Motoya, Inaba Yuhei, Ito Takahiro, Moriichi Kentaro, Tanabe Hiroki, Saitoh Yusuke, Kohgo Yutaka
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
Digestive Disease Center, Asahikawa City Hospital, Asahikawa, Japan.
Gastrointest Endosc. 2014 Dec;80(6):1064-71. doi: 10.1016/j.gie.2014.03.030. Epub 2014 May 13.
No method for sufficiently making the differential diagnosis of intestinal lymphoma resembling lymphoid hyperplasia (LH) on endoscopy has yet been established.
The aim of this study was to evaluate the usefulness of narrow-band imaging (NBI) in diagnosing intestinal lymphoma.
Prospective study.
Single-center study.
Sixty-one patients with primary or systemic lymphoma were enrolled in this study.
The terminal ileum and entire colon were observed by using conventional endoscopy. NBI was subsequently performed when small polypoid lesions were detected. A decrease in the number of vascular networks (DVNs) and the presence of irregular vessels on the surface of the epithelia were defined as characteristic findings of intestinal lymphoma. The diagnostic accuracy of these 2 findings in distinguishing intestinal lymphoma from LH was examined.
The ability to use NBI to distinguish intestinal lymphoma from LH.
Two hundred ninety-four small polypoid lesions, including 59 lymphomas and 235 LH lesions, were detected. The rates of detecting DVNs and the presence of irregular vessels were significantly higher in the lymphoma samples (81.4% and 62.7%) than in the LH samples (25.5% and 4.7%). Based on these findings, the diagnostic accuracy, sensitivity, specificity, and positive and negative predictive values for differentiating intestinal lymphoma from LH were 88.8%, 62.7%, 95.3%, 77.1%, and 91.1%, respectively, which are significantly higher than those of conventional endoscopy.
Single-center study.
DVNs and the presence of irregular vessels on NBI are thus considered to be useful findings for differentiating intestinal lymphoma from benign LH.
目前尚未建立在内镜检查中充分鉴别酷似淋巴样增生（LH）的肠道淋巴瘤的方法。
本研究旨在评估窄带成像（NBI）在诊断肠道淋巴瘤中的实用性。
前瞻性研究。
单中心研究。
61例原发性或全身性淋巴瘤患者纳入本研究。
采用传统内镜观察回肠末端和整个结肠。随后，当检测到小的息肉样病变时进行NBI检查。血管网数量减少（DVNs）和上皮表面出现不规则血管被定义为肠道淋巴瘤的特征性表现。检查这两个表现鉴别肠道淋巴瘤与LH的诊断准确性。
使用NBI鉴别肠道淋巴瘤与LH的能力。
共检测到294个小的息肉样病变，包括59个淋巴瘤和235个LH病变。淋巴瘤样本中检测到DVNs和出现不规则血管的比例（分别为81.4%和62.7%）显著高于LH样本（分别为25.5%和4.7%）。基于这些发现，鉴别肠道淋巴瘤与LH的诊断准确性、敏感性、特异性、阳性和阴性预测值分别为88.8%、62.7%、95.3%、77.1%和91.1%，均显著高于传统内镜检查。
单中心研究。
因此，NBI上的DVNs和出现不规则血管被认为是鉴别肠道淋巴瘤与良性LH的有用表现。
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