醋酸喷雾联合窄带成像技术在识别无蒂锯齿状病变边缘中的应用价值
Usefulness of Acetic Acid Spray with Narrow-Band Imaging for Identifying the Margin of Sessile Serrated Lesions.
作者信息
Kono Yoshiyasu, Higashi Reiji, Mizushima Hidetaka, Shimizu Daisuke, Katayama Tetsuya, Kosaka Masanari, Hirata Issei, Hirata Tetsu, Gotoda Tatsuhiro, Miyahara Koji, Moritou Yuki, Kunihiro Masaki, Nakagawa Masahiro, Ichimura Koichi, Okada Hiroyuki
机构信息
Department of Internal Medicine, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-Machi, Naka-ku, Hiroshima, 730-8518, Japan.
Department of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
出版信息
Dig Dis Sci. 2023 Jun;68(6):2553-2560. doi: 10.1007/s10620-022-07816-x. Epub 2023 Jan 7.
BACKGROUND
Sessile serrated lesions (SSLs) are precursors of colon cancer, especially in cases of large, right colon. However, they are difficult to not only detect, but only clarify the margin of the lesion, which can lead to the poor endoscopic treatment outcomes.
AIMS
This study evaluated the usefulness of acetic acid spray with narrow-band imaging (A-NBI) for the better visualization of the margin of SSLs.
METHODS
From January 2013 to March 2022, patients with superficial elevated polyps suspected of being SSLs ≥ 10 mm with an endoscopic diagnosis that had been endoscopically resected at Hiroshima City Hiroshima Citizens Hospital were enrolled. Endoscopic images with white-light imaging (WLI), narrow-band imaging (NBI), indigo-carmine (IC), and A-NBI were recorded in each lesion and were randomly arranged and assessed by 10 endoscopists. We compared the visibility score (1 to 4) and color differences (ΔE) between inside and outside of the lesions among WLI, NBI, IC, and A-NBI.
RESULTS
Forty-one lesions in 33 cases were included, and a total of 164 images were evaluated. As for the visibility score, most of the lesions were scored as 1 or 2 on WLI, whereas most were scored 4 on A-NBI. The median ΔE of A-NBI was also significantly higher than that of WLI, NBI, or IC (20.5 vs. 8.3 vs. 8.2 vs. 12.3, P < 0.01). A significant correlation was observed between the color difference and visibility score (r = 0.53, P < 0.01).
CONCLUSIONS
A-NBI may be a useful modality for identifying the margin of SSLs.
背景
无蒂锯齿状病变（SSLs）是结肠癌的癌前病变，尤其是在大的右半结肠病例中。然而，它们不仅难以检测，而且难以明确病变边界，这可能导致内镜治疗效果不佳。
目的
本研究评估了醋酸喷雾联合窄带成像（A-NBI）在更好地显示SSLs边界方面的实用性。
方法
纳入2013年1月至2022年3月在广岛市立广岛市民医院接受内镜下切除的、内镜诊断为疑似SSLs且直径≥10mm的浅表隆起性息肉患者。在每个病变处记录白光成像（WLI）、窄带成像（NBI）、靛胭脂（IC）和A-NBI的内镜图像，并随机排列，由10位内镜医师进行评估。我们比较了WLI、NBI、IC和A-NBI之间病变内部和外部的可视性评分（1至4分）和颜色差异（ΔE）。
结果
纳入33例患者的41个病变，共评估164幅图像。关于可视性评分，大多数病变在WLI上评分为1或2分，而在A-NBI上大多数评分为4分。A-NBI的ΔE中位数也显著高于WLI、NBI或IC（20.5对8.3对8.2对12.3，P<0.01）。颜色差异与可视性评分之间存在显著相关性（r=0.53，P<0.01）。
结论
A-NBI可能是识别SSLs边界的一种有用方法。
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