Lahiff Conor, East James E
Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK.
Frontline Gastroenterol. 2017 Apr;8(2):98-103. doi: 10.1136/flgastro-2016-100777. Epub 2017 Feb 10.
Identification and complete resection of colorectal polyps provide a significant mortality benefit from colorectal cancer. With improvements in colonoscopic techniques and advanced endoscopic imaging techniques, polyp detection has taken on greater complexity since the establishment of bowel cancer screening programmes internationally. All endoscopists operating within symptomatic and screening populations should be aware of endoscopic features associated with advanced neoplasia. Chromoendoscopy and advanced imaging techniques, such as narrow spectrum technologies (narrow band imaging, flexible spectral imaging colour enhancement (FICE) and i-Scan digital contrast (iSCAN)), have specific classification systems to support accurate lesion characterisation. This review summarises the evidence in relation to polyp detection, recognition and characterisation as well as the identification of features of invasion. Future areas of interest include optimal management of large polyps, incorporation of a 'detect, resect and discard' strategy for small and diminutive polyps, expected wider use of computer decision support tools (artificial intelligence and deep learning) and the use of fluorescently labelled molecular probes to improve detection and assessment of neoplasia.
识别并完整切除大肠息肉可显著降低结直肠癌的死亡率。随着结肠镜技术和先进内镜成像技术的改进，自国际上开展肠癌筛查项目以来，息肉检测变得更加复杂。所有在有症状人群和筛查人群中操作的内镜医师都应了解与高级别瘤变相关的内镜特征。染色内镜和先进成像技术，如窄谱技术（窄带成像、灵活光谱成像颜色增强（FICE）和i-Scan数字对比（iSCAN）），有特定的分类系统来支持准确的病变特征描述。本综述总结了有关息肉检测、识别和特征描述以及浸润特征识别的证据。未来感兴趣的领域包括大息肉的最佳管理、对小息肉和微小息肉采用“检测、切除并丢弃”策略、预计计算机决策支持工具（人工智能和深度学习）的更广泛应用以及使用荧光标记分子探针来改善瘤变的检测和评估。
