Tamai Naoto, Inomata Hiroko, Ide Daisuke, Dobashi Akira, Saito Shoichi, Sumiyama Kazuki
Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Dig Endosc. 2016 Apr;28 Suppl 1:49-52. doi: 10.1111/den.12602.
We previously reported the effectiveness of color intensity analysis using autofluorescence imaging (AFI) for differentiating colorectal neoplastic lesions from non-neoplastic lesions. However, the ability of AFI systems for differentiating serrated lesions has not been evaluated. In the present study, we assessed the effectiveness of color intensity analysis using updated AFI systems for evaluating serrated lesions.
We retrospectively reviewed the data for 48 consecutive patients with 87 serrated lesions that were examined using updated AFI systems and resected at Jikei University Hospital. The mean green/red (G/R) ratio, which is obtained by dividing the mean green color intensities by the mean red color intensities, was calculated for each serrated lesion and compared between hyperplastic polyps, sessile serrated adenomas/polyps (SSA/P) with cytological dysplasia, and SSA/P without cytological dysplasia. We also assessed the area under the receiver operating characteristic curve (AUC) for determining SSA/P (both with and without cytological dysplasia) and SSA/P with cytological dysplasia.
The AUC for determining SSA/P was 0.68; however, the AUC for determining SSA/P with cytological dysplasia was 0.97. With a cut-off for the G/R ratio of <0.93, the sensitivity, specificity, positive predictive value, and negative predictive value for SSA/P with cytological dysplasia were 95.5%, 91.0%, 77.8%, and 98.3%, respectively.
Color intensity analysis of serrated lesions using updated AFI systems could effectively distinguish SSA/P with cytological dysplasia from hyperplastic polyps and SSA/P without cytological dysplasia.
我们之前报道了利用自体荧光成像（AFI）进行颜色强度分析以区分结直肠肿瘤性病变与非肿瘤性病变的有效性。然而，AFI系统区分锯齿状病变的能力尚未得到评估。在本研究中，我们评估了使用更新后的AFI系统进行颜色强度分析对评估锯齿状病变的有效性。
我们回顾性分析了连续48例患者中87个锯齿状病变的数据，这些病变使用更新后的AFI系统进行了检查，并在东京慈惠会医科大学医院接受了切除。计算每个锯齿状病变的平均绿色/红色（G/R）比值，即通过将平均绿色强度除以平均红色强度获得，并在增生性息肉、伴有细胞学异型增生的无蒂锯齿状腺瘤/息肉（SSA/P）和不伴有细胞学异型增生的SSA/P之间进行比较。我们还评估了用于确定SSA/P（伴有和不伴有细胞学异型增生）以及伴有细胞学异型增生的SSA/P的受试者操作特征曲线（AUC）下的面积。
确定SSA/P的AUC为0.68；然而，确定伴有细胞学异型增生的SSA/P的AUC为0.97。对于伴有细胞学异型增生的SSA/P，当G/R比值的截断值<0.93时，敏感性、特异性、阳性预测值和阴性预测值分别为95.5%、91.0%、77.8%和98.3%。
使用更新后的AFI系统对锯齿状病变进行颜色强度分析可以有效地将伴有细胞学异型增生的SSA/P与增生性息肉和不伴有细胞学异型增生的SSA/P区分开来。
