2nd Department of Internal Medicine, Osaka Medical College, Japan.
Endoscopy Division, National Cancer Center Hospital, Japan.
Intern Med. 2021 Jun 15;60(12):1805-1812. doi: 10.2169/internalmedicine.6446-20. Epub 2021 Jan 15.
Objective Although colorectal polyps (CPs) can be observed with colon capsule endoscopy (CCE), it is difficult to determine the type of polyp using CCE. The objective of this study was to differentiate adenomatous polyps (APs) from hyperplastic polyps (HPs) with CCE. Methods In this single-center retrospective study, an analysis was conducted on the same CPs with both CCE and colonoscopy (CS) and histopathologically diagnosed as AP or HP. The color difference (ΔE) between the polyp surface and the surrounding mucosa was calculated using the CIE1976 Lab* color space method on white light (WL), flexible spectral imaging color enhancement (FICE), and blue mode (BM) CP images. We investigated the ability of the ratio of the color differences (ΔE') to differentiate between APs and HPs. Results The size of all 51 polyps (34 APs, 17 HPs) was 7.5±4.6 mm with CCE and 7.3±4.2 mm with CS, and this difference was not significant (p=0.28). The FICEΔE' of APs was 3.3±1.8, which was significantly higher than the FICEΔE' of HPs (1.3±0.6; p<0.001). A receiver operating characteristic analysis showed that FICEΔE' was useful for differentiating between APs and HPs, with an area under the curve of 0.928 (95% confidence interval, 0.843-1). The sensitivity was 91.2%, and the specificity was 88.2% with a cut-off value of 1.758. Conclusion Using FICE on CCE images of CPs and applying the CIELAB color space method, we were able to differentiate between APs and HPs with high accuracy. This method has the potential to reduce unnecessary CS procedures.
目的 虽然结肠胶囊内镜（CCE）可观察到结直肠息肉（CPs），但使用 CCE 很难确定息肉的类型。本研究的目的是使用 CCE 区分腺瘤性息肉（APs）和增生性息肉（HPs）。
方法 本单中心回顾性研究对同一 CCE 和结肠镜（CS）检查并经组织病理学诊断为 AP 或 HP 的 CPs 进行了分析。使用 CIE1976 Lab*颜色空间法，在白光（WL）、柔性光谱成像颜色增强（FICE）和蓝色模式（BM）CP 图像上计算息肉表面与周围黏膜之间的颜色差异（ΔE）。我们研究了颜色差异比（ΔE'）来区分 AP 和 HP 的能力。
结果 51 个息肉（34 个 AP，17 个 HP）的大小在 CCE 下为 7.5±4.6mm，在 CS 下为 7.3±4.2mm，差异无统计学意义（p=0.28）。AP 的 FICEΔE'为 3.3±1.8，明显高于 HP 的 FICEΔE'（1.3±0.6；p<0.001）。受试者工作特征分析显示，FICEΔE' 有助于区分 AP 和 HP，曲线下面积为 0.928（95%置信区间，0.843-1）。灵敏度为 91.2%，特异性为 88.2%，截断值为 1.758。
结论 使用 CCE 上的 FICE 对 CPs 进行成像，并应用 CIELAB 颜色空间方法，我们能够准确地区分 AP 和 HP。这种方法有可能减少不必要的 CS 程序。
