白光成像与窄带成像在鉴别结直肠肿瘤性和非肿瘤性息肉中的性能比较
Comparison of Performance between White Light Imaging and Narrow Band Imaging in Distinguishing Neoplastic and Non-neoplastic Colorectal Polyps.
作者信息
Renaldi Kaka, Verawati Lily, Maulahela Hasan, Rahadiani Nur, Rizka Aulia, Fahrial Syam Ari, Purnamasari Dyah, Maurine Jasirwan Chyntia Olivia, Tahapary Dicky Levenus
机构信息
Division of Gastroenterology, Pancreatobiliary, and Gastroenterological Endoscopy, Department of Internal Medicine, Faculty of Medicine-University of Indonesia, Dr. Cipto Mangunkusumo National Hospital, Jakarta.
Department of Internal Medicine, Faculty of Medicine-University of Indonesia, Dr. Cipto Mangunkusumo National Hospital, Jakarta.
出版信息
Middle East J Dig Dis. 2025 Jan;17(1):19-24. doi: 10.34172/mejdd.2025.405. Epub 2025 Jan 31.
BACKGROUND
White light imaging (WLI) is the current standard colonoscopy technique for diagnosing colorectal polyps in Indonesia. Various endoscopic imaging techniques have been developed to improve the accuracy of diagnosing colorectal polyps, one of which is narrow band imaging (NBI). We conducted a diagnostic study comparing the performance of NBI against WLI in distinguishing neoplastic from non-neoplastic colorectal polyps.
METHODS
This was a diagnostic study that analyzes endoscopic pictures of colorectal polyps in patients who underwent colonoscopy using the WLI and NBI techniques. Previously collected biopsy tissue specimens were re-examined by a single pathologist.
RESULTS
There were 117 subjects analyzed, and the proportion of subjects with neoplastic polyps was 65.8%. Common indications for colonoscopy were hematochezia (24.8%) and abdominal pain (23.9%). WLI showed moderate inter-observer reliability (kappa value=0.591), while NBI showed significant reliability (kappa value=0.674). NBI demonstrated better sensitivity (84.4%; 95% CI 74.4%-91.7%) and accuracy (78.6%; 95% CI 70.1%-85.7%) compared with WLI (sensitivity 74%; 95% CI 62.8%-83.4% and accuracy 71.8%; 95% CI 62.7%-79.7%). However, the specificity was the same (67.5%; 95% CI 50.9%-81.4%).
CONCLUSION
NBI has better performance than WLI in distinguishing neoplastic and non-neoplastic colorectal polyps.
背景
白光成像（WLI）是印度尼西亚目前用于诊断大肠息肉的标准结肠镜检查技术。为提高大肠息肉诊断的准确性，已开发出多种内镜成像技术，其中之一是窄带成像（NBI）。我们进行了一项诊断研究，比较NBI与WLI在区分肿瘤性和非肿瘤性大肠息肉方面的性能。
方法
这是一项诊断研究，分析了使用WLI和NBI技术进行结肠镜检查的患者的大肠息肉内镜图像。由一名病理学家重新检查先前收集的活检组织标本。
结果
共分析了117名受试者，肿瘤性息肉受试者的比例为65.8%。结肠镜检查的常见指征是便血（24.8%）和腹痛（23.9%）。WLI显示观察者间可靠性中等（kappa值=0.591），而NBI显示出显著的可靠性（kappa值=0.674）。与WLI相比，NBI表现出更好的敏感性（84.4%；95%CI 74.4%-91.7%）和准确性（78.6%；95%CI 70.1%-85.7%）（敏感性74%；95%CI 62.8%-83.4%，准确性71.8%；95%CI 62.7%-79.7%）。然而，特异性相同（67.5%；95%CI 50.9%-81.4%）。
结论
在区分肿瘤性和非肿瘤性大肠息肉方面，NBI的性能优于WLI。
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