论文部分内容阅读
目的探讨高分辨率数字染色内镜筛查直肠异常隐窝灶的价值,从而寻找新的大肠癌癌前病变筛查的有效方法。方法选取2011年3月至2011年8月于南方医科大学第三附属医院消化内镜中心行结肠镜检查的患者,采用“背靠背”的检查方案筛查直肠异常隐窝灶,每例患者随机取1块异常隐窝灶行组织病理学检查。结果 428例患者中,高清(HD)模式发现异常隐窝灶数目553个,平均(1.29±2.423)个;HD+i-scan模式发现异常隐窝灶1024个,平均(2.39±3.984)个,HD和HD+i-scan模式异常隐窝灶检出率差异有统计学意义(F=134.405,P<0.01)。高分辨率数字染色内镜预判异型性直肠异常隐窝灶的灵敏度为47.1%,特异度为96.8%,与组织病理学诊断的吻合系数κ=0.490(P<0.001)。结论高分辨率数字染色内镜能清晰识别人直肠异常隐窝灶,并能通过iscan功能较好地预判其性质,在大肠癌癌前病变的筛查中有较大的应用前景。
Objective To explore the value of high-resolution digital staining endoscopy screening abnormal rectal crypts, in order to find a new screening method for colorectal cancer precancerous lesions. Methods From March 2011 to August 2011, patients undergoing colonoscopy at the digestive endoscopy center of the Third Affiliated Hospital of Southern Medical University were enrolled in this study. The patients with abnormal rectal crypt Randomly take an abnormal crypt foci histopathological examination. Results Among 428 patients, there were 553 (1.29 ± 2.423) anomalous crypts found in high-definition (HD) patterns. There were 1024 abnormal crypts in HD + i-scan pattern with an average of 2.39 ± 3.984, The detection rates of abnormal crypts in HD and HD + i-scan patterns were statistically different (F = 134.405, P <0.01). The sensitivity and specificity of high resolution digital staining endoscopy for predicting atypical rectal crypts were 47.1% and 96.8%, respectively, which were consistent with histopathological diagnosis (P <0.001). Conclusion High-resolution digital staining endoscopy can clearly identify the abnormal rectal crypts in human rectum and can predict its properties better with iscan function. It has a great potential in the screening of precancerous lesions of colorectal cancer.