Sano Yasushi, Tanaka Shinji, Kudo Shin-Ei, Saito Shoichi, Matsuda Takahisa, Wada Yoshiki, Fujii Takahiro, Ikematsu Hiroaki, Uraoka Toshio, Kobayashi Nozomu, Nakamura Hisashi, Hotta Kinichi, Horimatsu Takahiro, Sakamoto Naoto, Fu Kuang-I, Tsuruta Osamu, Kawano Hiroshi, Kashida Hiroshi, Takeuchi Yoji, Machida Hirohisa, Kusaka Toshihiro, Yoshida Naohisa, Hirata Ichiro, Terai Takeshi, Yamano Hiro-O, Kaneko Kazuhiro, Nakajima Takeshi, Sakamoto Taku, Yamaguchi Yuichiro, Tamai Naoto, Nakano Naoko, Hayashi Nana, Oka Shiro, Iwatate Mineo, Ishikawa Hideki, Murakami Yoshitaka, Yoshida Shigeaki, Saito Yutaka
Sano Hospital, Kobe, Japan.
Hiroshima University, Hiroshima, Japan.
Dig Endosc. 2016 Jul;28(5):526-33. doi: 10.1111/den.12644. Epub 2016 Apr 20.
Many clinical studies on narrow-band imaging (NBI) magnifying endoscopy classifications advocated so far in Japan (Sano, Hiroshima, Showa, and Jikei classifications) have reported the usefulness of NBI magnifying endoscopy for qualitative and quantitative diagnosis of colorectal lesions. However, discussions at professional meetings have raised issues such as: (i) the presence of multiple terms for the same or similar findings; (ii) the necessity of including surface patterns in magnifying endoscopic classifications; and (iii) differences in the NBI findings in elevated and superficial lesions. To resolve these problems, the Japan NBI Expert Team (JNET) was constituted with the aim of establishing a universal NBI magnifying endoscopic classification for colorectal tumors (JNET classification) in 2011. Consensus was reached on this classification using the modified Delphi method, and this classification was proposed in June 2014. The JNET classification consists of four categories of vessel and surface pattern (i.e. Types 1, 2A, 2B, and 3). Types 1, 2A, 2B, and 3 are correlated with the histopathological findings of hyperplastic polyp/sessile serrated polyp (SSP), low-grade intramucosal neoplasia, high-grade intramucosal neoplasia/shallow submucosal invasive cancer, and deep submucosal invasive cancer, respectively.
目前在日本提倡的许多关于窄带成像（NBI）放大内镜分类的临床研究（佐野、广岛、昭和及慈惠会分类）均报告了NBI放大内镜在结直肠病变定性和定量诊断方面的有用性。然而，专业会议上的讨论提出了以下问题：（i）对于相同或相似发现存在多个术语；（ii）在放大内镜分类中纳入表面模式的必要性；（iii）隆起性病变和浅表性病变的NBI表现差异。为解决这些问题，日本NBI专家团队（JNET）于2011年成立，旨在建立一种适用于结直肠肿瘤的通用NBI放大内镜分类（JNET分类）。采用改良德尔菲法就该分类达成了共识，并于2014年6月提出了此分类。JNET分类由血管和表面模式的四类（即1型、2A 型、2B 型和3型）组成。1型、2A 型、2B 型和3型分别与增生性息肉/无蒂锯齿状息肉（SSP）、低级别黏膜内瘤变、高级别黏膜内瘤变/浅肌层浸润癌和深肌层浸润癌的组织病理学表现相关。
