Zhao Jia-Hao, Rong Ai-Mei, Wu Hui-Li, Chang Ning, Jiang Yuan-Yuan, Li Kun-Kun, Liang Qian-Ping
Department of Gastroenterology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhongyuan District, No. 195, Tongbai Road, Zhengzhou, China.
Int J Colorectal Dis. 2025 Feb 1;40(1):30. doi: 10.1007/s00384-025-04814-z.
This study compared the diagnostic performance of standard endoscopic ultrasound (EUS) and submucosal injection of normal saline and epinephrine-enhanced EUS (SINE-EUS) in detecting early colorectal cancer (CRC), emphasizing accuracy, sensitivity, and specificity.
The self-controlled study was conducted with 115 patients diagnosed with early CRC through optical enhancement (OE) magnified endoscopy. Among them, 104 patients underwent sequential diagnostic procedures, starting with standard EUS and followed by SINE-EUS. Pathological findings were used as the reference standard. Statistical analyses assessed the diagnostic metrics and identified factors influencing accuracy.
Among 104 patients, 82 were pathologically diagnosed with early CRC (63 cases of Tis/T1a and 19 cases of T1b). Standard EUS showed a sensitivity of 68.3%, specificity of 52.6%, and overall accuracy of 64.6%. In contrast, SINE-EUS significantly improved sensitivity (85.7%), specificity (68.4%), and overall accuracy (81.7%) (P < 0.0167). Risk factors such as ulceration were identified as independent predictors of reduced diagnostic accuracy.
SINE-EUS outperforms standard EUS in diagnosing early CRC, particularly in terms of sensitivity and overall accuracy. This technique is reliable for clinical application, although limitations remain in improving specificity for deeper lesions.
本研究比较了标准内镜超声（EUS）以及生理盐水和肾上腺素黏膜下注射增强内镜超声（SINE - EUS）在检测早期结直肠癌（CRC）方面的诊断性能，重点关注准确性、敏感性和特异性。
对115例经光学增强（OE）放大内镜诊断为早期CRC的患者进行自身对照研究。其中，104例患者依次接受诊断程序，先进行标准EUS，然后进行SINE - EUS。病理结果用作参考标准。统计分析评估诊断指标并确定影响准确性的因素。
104例患者中，82例经病理诊断为早期CRC（63例Tis/T1a和19例T1b）。标准EUS的敏感性为68.3%，特异性为52.6%，总体准确性为64.6%。相比之下，SINE - EUS显著提高了敏感性（85.7%）、特异性（68.4%）和总体准确性（81.7%）（P < 0.0167）。溃疡等危险因素被确定为诊断准确性降低的独立预测因素。
SINE - EUS在诊断早期CRC方面优于标准EUS，特别是在敏感性和总体准确性方面。尽管在提高对更深层病变的特异性方面仍存在局限性，但该技术在临床应用中是可靠的。
