Zheng Li-Juan, Huang Xin-Xiang, Lu Zhi-Zhong, Wu Hui-Feng, Lv Dong-Dong
Endoscopy Center, Affiliated Hospital of Putian University, Putian, China.
Transl Cancer Res. 2022 Dec;11(12):4389-4396. doi: 10.21037/tcr-22-2566.
Endoscopic ultrasonography is an effective endoscopic examination method for determining the depth of colorectal cancer invasion. Narrow-band imaging (NBI) techniques increase the contrast of vascular structures and more clearly highlight subtle structures on mucosal surfaces, thereby improving the accuracy of endoscopic assessment. This study investigated the diagnostic efficacy of NBI in colorectal laterally spreading tumor (LST) and its submucosal invasion.
A total of 224 patients with colorectal LST admitted to the Affiliated Hospital of Putian University from January 2015 to December 2021 were enrolled in this study. The patients were divided into NBI and endoscopic ultrasonography groups according to the different examination methods they received. Subsequently, the clinicopathological characteristics of the patients were collected, and the rates of submucosal invasion of the four subtypes (LST-G-H, LST-G-NM, LST-NG-F, LST-NG-PD) were compared between the two groups. Also, the accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of judging the depth of LST lesions of the two examination methods were compared, taking the results of pathological tissue examination as the gold standard.
This study enrolled 224 patients with LST (mean onset age: 57.98±6.48 years), including 123 males and 101 females. In terms of tumor location, 21 cases were located in the cecum, 22 cases in the ascending colon, 38 cases in the transverse colon, 11 cases in the descending colon, 12 cases in the descending sigmoid junction, 23 cases in the sigmoid colon, and 97 cases in the rectum. The sizes of the tumors ranged from 18.81 to 52.88 mm. Moreover, there were 21 cases of lesion infiltration into the submucosa, and the infiltration rate was 9.38%. Furthermore, the accuracy of NBI in diagnosing colorectal LST was significantly higher than that of endoscopic ultrasonography (87.05% 57.14%); NBI was more accurate than endoscopic ultrasonography in the preoperative diagnosis of LST lesion depth in the rectal, non-rectal, granular (LST-G), non-granular (LST-NG), <40, and ≥40 mm groups.
Gastrointestinal NBI has a superior accuracy rate and value than endoscopic ultrasonography in diagnosing colorectal LST, tumor lesion depth, and submucosal invasion. Therefore, gastrointestinal NBI deserves to be promoted in clinical work.
内镜超声检查是确定结直肠癌浸润深度的一种有效的内镜检查方法。窄带成像（NBI）技术可增加血管结构的对比度，更清晰地突出黏膜表面的细微结构，从而提高内镜评估的准确性。本研究探讨了NBI在结直肠侧向发育型肿瘤（LST）及其黏膜下浸润诊断中的效能。
选取2015年1月至2021年12月在莆田学院附属医院收治的224例结直肠LST患者纳入本研究。根据患者接受的不同检查方法将其分为NBI组和内镜超声检查组。随后，收集患者的临床病理特征，比较两组中四种亚型（LST-G-H、LST-G-NM、LST-NG-F、LST-NG-PD）的黏膜下浸润率。同时，以病理组织检查结果为金标准，比较两种检查方法判断LST病变深度的准确性、敏感性、特异性、阳性预测值、阴性预测值及准确率。
本研究纳入224例LST患者（平均发病年龄：57.98±6.48岁），其中男性123例，女性101例。肿瘤部位方面，盲肠21例，升结肠22例，横结肠38例，降结肠11例，降乙状结肠交界处12例，乙状结肠23例，直肠97例。肿瘤大小范围为18.81至52.88mm。此外，有21例病变浸润至黏膜下层，浸润率为9.38%。而且，NBI诊断结直肠LST的准确性显著高于内镜超声检查（87.05%对57.14%）；在直肠、非直肠、颗粒状（LST-G）、非颗粒状（LST-NG）、<40mm和≥40mm组中，NBI在术前诊断LST病变深度方面比内镜超声检查更准确。
在诊断结直肠LST、肿瘤病变深度及黏膜下浸润方面，胃肠道NBI比内镜超声检查具有更高的准确率和价值。因此，胃肠道NBI在临床工作中值得推广。
