窄带成像联合或不联合双焦点放大在小的结直肠息肉肿瘤性预测中的应用：越南的经验
Utility of narrow-band imaging with or without dual focus magnification in neoplastic prediction of small colorectal polyps: a Vietnamese experience.
作者信息
Huynh Tien Manh, Le Quang Dinh, Le Nhan Quang, Le Huy Minh, Quach Duc Trong
机构信息
Department of Internal Medicine, University of Medicine and Pharmacy at Hochiminh City, Ho Chi Minh City, Vietnam.
Department of Endoscopy, University Medical Center, Ho Chi Minh City, Vietnam.
出版信息
Clin Endosc. 2023 Jul;56(4):479-489. doi: 10.5946/ce.2022.212. Epub 2023 May 24.
BACKGROUND/AIMS: Accurate neoplastic prediction can significantly decrease costs associated with pathology and unnecessary colorectal polypectomies. Narrow band imaging (NBI) and dual-focus (DF) mode are promising emerging optical technologies for recognizing neoplastic features of colorectal polyps digitally. This study aimed to clarify the clinical usefulness of NBI with and without DF assistance in the neoplastic prediction of small colorectal polyps (<10 mm).
METHODS
This cross-sectional study included 530 small colorectal polyps from 343 consecutive patients who underwent colonoscopy at the University Medical Center from September 2020 to May 2021. Each polyp was endoscopically diagnosed in three successive steps using white-light endoscopy (WLE), NBI, and NBI-DF and retrieved for histopathological assessment. The diagnostic accuracy of each modality was evaluated with reference to histopathology.
RESULTS
There were 295 neoplastic polyps and 235 non-neoplastic polyps. The overall accuracies of WLE, WLE+NBI, and WLE+NBI+NBI-DF in the neoplastic prediction of colorectal polyps were 70.8%, 87.4%, and 90.8%, respectively (p<0.001). The accuracy of WLE+NBI+NBI-DF was significantly higher than that of WLE+NBI in the polyp size ≤5 mm subgroup (87.3% vs. 90.1%, p<0.001).
CONCLUSION
NBI improved the real-time neoplastic prediction of small colorectal polyps. The DF mode was especially useful in polyps ≤5 mm in size.
背景/目的：准确的肿瘤预测可显著降低与病理学相关的成本以及不必要的大肠息肉切除术。窄带成像（NBI）和双聚焦（DF）模式是用于数字识别大肠息肉肿瘤特征的有前景的新兴光学技术。本研究旨在阐明在有无DF辅助的情况下NBI在小的大肠息肉（<10mm）肿瘤预测中的临床实用性。
方法
这项横断面研究纳入了2020年9月至2021年5月在大学医学中心接受结肠镜检查的343例连续患者的530个小的大肠息肉。每个息肉依次通过白光内镜检查（WLE）、NBI和NBI-DF进行三步内镜诊断，并获取组织进行病理评估。参照组织病理学评估每种检查方式的诊断准确性。
结果
有295个肿瘤性息肉和235个非肿瘤性息肉。WLE、WLE+NBI和WLE+NBI+NBI-DF在大肠息肉肿瘤预测中的总体准确率分别为70.8%、87.4%和90.8%（p<0.001）。在息肉大小≤5mm亚组中，WLE+NBI+NBI-DF的准确率显著高于WLE+NBI（87.3%对90.1%，p<0.001）。
结论
NBI提高了小的大肠息肉的实时肿瘤预测能力。DF模式在大小≤5mm的息肉中尤其有用。
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