Kudo S, Tamura S, Nakajima T, Yamano H, Kusaka H, Watanabe H
Department of Gastroenterology, Akita Red Cross Hospital, Japan.
Gastrointest Endosc. 1996 Jul;44(1):8-14. doi: 10.1016/s0016-5107(96)70222-5.
The magnifying colonoscope allows 100-fold magnified viewing of the colonic surface.
We examined 2050 colorectal tumorous lesions by magnifying endoscopy, stereomicroscopy, and histopathology and classified these lesions according to pit pattern. Based on stereomicroscopy, lesions with a type 1 or 2 pit pattern were nontumors, whereas lesions with types 3s, 3L, 4, and/or 5 pit patterns were neoplastic tumors.
The pit patterns observed by magnifying endoscopy were fundamentally similar to those demonstrated in stereomicroscopic images. When the diagnosis by magnifying endoscopy was compared with the stereomicroscopic diagnosis, there was agreement in 1130 of 1387 lesions (81.5%). True neoplasms could be differentiated from non-neoplastic lesions. Of lesions with a type 5 pit pattern with a bounded surface, 11 of 22 (50%) were found to be invasive cancers with involvement of the submucosal layer. If this pit pattern is found to involve a relatively broad area of the mucosal surface, extensive malignant invasion (sm-massive) should be strongly suspected.
The magnifying colonoscope provides an accurate instantaneous assessment of the histology of colorectal tumorous lesions. This may help in decision making during colonoscopy.
放大结肠镜可对结肠表面进行100倍放大观察。
我们通过放大内镜检查、体视显微镜检查和组织病理学检查了2050例结直肠肿瘤性病变，并根据凹陷模式对这些病变进行分类。基于体视显微镜检查，凹陷模式为1型或2型的病变为非肿瘤性病变，而凹陷模式为3s、3L、4型和/或5型的病变为肿瘤性肿瘤。
放大内镜观察到的凹陷模式与体视显微镜图像中显示的基本相似。将放大内镜诊断与体视显微镜诊断进行比较时，1387例病变中有1130例（81.5%）诊断一致。真正的肿瘤可以与非肿瘤性病变区分开来。在表面有边界的5型凹陷模式病变中，22例中有11例（50%）被发现为侵犯黏膜下层的浸润性癌。如果发现这种凹陷模式累及黏膜表面相对较广的区域，则应高度怀疑有广泛的恶性浸润（黏膜下大量浸润）。
放大结肠镜能对结直肠肿瘤性病变的组织学进行准确的即时评估。这可能有助于结肠镜检查过程中的决策。
