Szura Mirosław, Pasternak Artur, Bucki Krzysztof, Urbańczyk Katarzyna, Matyja Andrzej
First Department, General, Oncological and Gastrointestinal Surgery, Jagiellonian University Medical College, 40th Kopernika St., 31-501, Kraków, Poland.
Department of Anatomy, Jagiellonian University Medical College, 12th Kopernika St., 31-034, Kraków, Poland.
Surg Endosc. 2016 Jan;30(1):204-14. doi: 10.1007/s00464-015-4186-x. Epub 2015 Apr 4.
Macroscopic real-time evaluations of the histopathology and degree of invasion of colorectal polyps help to select the most suitable endoscopic treatment method. Dual-focus (DF) narrow-band imaging (NBI) is a new imaging enhancement system that uses digital and optical methods to enhance the view of blood vessels on mucosal surfaces. However, the superiority of this technique over standard imaging techniques has not been previously reported. The aim of this study was to determine whether the two-stage optical systems in a new generation of endoscopes will increase the diagnostic accuracy of colorectal polyp recognition.
The study included 270 patients, and 386 colorectal polyps were diagnosed and removed. The polyps were assessed with white light and NBI using one- and two-stage optical systems, respectively. After being classified according to the Kudo pit pattern schemes, the polyps were removed and histopathologically verified.
Regarding non-neoplastic lesions (Kudo I and II), no difference was observed in the recognition of polyps when using the NBI-DF function. We observed improved accuracy in the preliminary diagnoses of Kudo IIIL lesions (from 87.16 to 90.09%, p < 0.05) and Kudo IIIS lesions (from 87.29 to 92.79%, p < 0.01). NBI-DF also increased the accuracy of preliminary diagnoses of Kudo IV lesions (from 88.24 to 94.12%, p < 0.01). The Kudo V pit patterns were also more distinct with NBI-DF imaging, increasing the diagnostic accuracy from 91.67 to 100%.
Using a two-stage optical system with electronic colorization of the mucosa increased diagnostic accuracy for differentiating colorectal polyps with neoplastic potential.
对结直肠息肉的组织病理学和浸润程度进行宏观实时评估有助于选择最合适的内镜治疗方法。双焦点（DF）窄带成像（NBI）是一种新的成像增强系统，它使用数字和光学方法来增强黏膜表面血管的视野。然而，该技术相对于标准成像技术的优越性此前尚未见报道。本研究的目的是确定新一代内镜中的两阶段光学系统是否会提高结直肠息肉识别的诊断准确性。
本研究纳入270例患者，共诊断并切除386枚结直肠息肉。分别使用单阶段和两阶段光学系统，通过白光和NBI对息肉进行评估。根据工藤凹坑模式方案进行分类后，切除息肉并进行组织病理学验证。
对于非肿瘤性病变（工藤I和II），使用NBI-DF功能时在息肉识别方面未观察到差异。我们观察到工藤IIIL型病变的初步诊断准确性有所提高（从87.16%提高到90.09%，p<0.05），工藤IIIS型病变也有所提高（从87.29%提高到92.79%，p<0.01）。NBI-DF还提高了工藤IV型病变初步诊断的准确性（从88.24%提高到94.12%，p<0.01）。工藤V型凹坑模式在NBI-DF成像下也更加清晰，诊断准确性从91.67%提高到100%。
使用带有黏膜电子染色的两阶段光学系统可提高鉴别具有肿瘤潜能的结直肠息肉的诊断准确性。
