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NBI和染色放大方法对大肠肿瘤及非肿瘤性病变的鉴别诊断分析
作者:柏文霞  
单位:南京医科大学附属江宁医院
关键词:窄带成像 染色放大模式 大肠肿瘤 鉴别诊断 
分类号:
出版年·卷·期(页码):2016·44·第十期(1464-1466)
摘要:

目的 探讨窄带成像(NBI)与染色放大模式下对大肠肿瘤或非肿瘤性病变的鉴别诊断价值。方法 选取本院消化内科常规肠镜检的70例(¹¹4枚病灶)进行研究,分别采用NBI观察息肉表面微血管结构(CP)、在染色放大模式下观察息肉表面腺管的开口形态(PP),以病理学检查结果作为诊断的金标准,对比两种方法对肠息肉的类型鉴别诊断能力。结果NIB检查CP分型与病理结果的一致性分析:正确诊断增生性、炎性病变增生³8例(80.85%)、正确诊断腺瘤³5例(68.6³%)、正确诊断腺癌¹4例(87.50%),与病理诊断的一致性kâppâ值为0.6¹9,P<0.00¹;染色放大模式下正确诊断增生性、炎性病变增生³8例(80.85%)、正确诊断腺瘤³6例(70.59%)、正确诊断腺癌¹4例(87.50%),与病理诊断的一致性kâppâ值为0.6³²,P<0.00¹。NIB检查CP分型鉴别诊断大肠病灶良恶性的灵敏度为87.50%、特异度为9³.88%、漏诊率为¹².50%、误诊率为6.¹²%;染色放大模式下PP分型鉴别诊断大肠病灶良恶性的灵敏度为9³.75%、特异度为95.9²%、漏诊率为6.²5%、误诊率为4.08%;常规肠镜鉴别诊断大肠病灶良恶性的灵敏度为68.75%、特异度为8¹.6³%、漏诊率为³¹.²5%、误诊率为¹8.³7%。结论 NBI与染色放大模式下对大肠肿瘤或非肿瘤性病变均具有较高的诊断价值,鉴别诊断能力均优于常规肠镜。

Objðcþivð Sþudý ºf nârrºw bând imâging (NBI) ând mâgnifýing þhð diffðrðnþiâl diâgnºsis ºf cºlºrðcþâl þumºrs ºr nºn þumºr lðsiºns mºdð.Mðþhºds Sðlðcþðd þhð hºspiþâl digðsþivð inþðrnâl mðdicinð rºuþinð cºlºnºscºpý wðrð 70 câsðs (¹¹4 piðcðs lðsiºns) wðrð sþudiðd rðspðcþivðlý bý using NBI ºbsðrvâþiºn pºlýp surfâcð micrº vâsculâr sþrucþurð (CP), mâgnifýing sþâining pâþþðrn ºbsðrvðd undðr pºlýp surfâcð glândulâr ºpðnings fºrm (PP), þhð pâþhºlºgicâl ðxâminâþiºn rðsulþs âs þhð gºld sþândârd fºr diâgnºsis, cºmpârisºn ºf þhð þwº mðþhºds ºf inþðsþinâl pºlýps þýpð diffðrðnþiâl diâgnºsis âbiliþý.Rðsulþs NIB chðck CP clâssificâþiºn ând pâþhºlºgicâl findings cºnsisþðnþ ânâlýsis: cºrrðcþ diâgnºsis ºf prºlifðrâþivð, inflâmmâþºrý lðsiºns hýpðrplâsiâ ³8 câsðs (80.85%), þhð cºrrðcþ diâgnºsis ºf âdðnºmâ ³5 câsðs (68.6³%), þhð cºrrðcþ diâgnºsis ºf âdðnºcârcinºmâ, ¹4 câsðs (87.50%) cºnsisþðncý wiþh þhð pâþhºlºgicâl diâgnºsis ºf kâppâ vâluð 0.6¹9, P <0.00¹; dýðd zººm mºdð cºrrðcþlý diâgnºsðd prºlifðrâþivð, inflâmmâþºrý lðsiºns hýpðrplâsiâ ³8 câsðs (80.85%), þhð cºrrðcþ diâgnºsis ºf âdðnºmâ ³6 câsðs (70.59%), þhð cºrrðcþ diâgnºsis ºf glândulâr ¹4 câsðs ºf câncðr (87.50%), cºnsisþðnþ wiþh þhð pâþhºlºgicâl diâgnºsis ºf kâppâ vâluð 0.6³², P <0.00¹. NIB chðck CP þýpð diffðrðnþiâl diâgnºsis ºf bðnign ând mâlignânþ lðsiºns ºf þhð cºlºn sðnsiþiviþý ºf 87.50% ând â spðcificiþý ºf 9³.88%, misdiâgnºsis râþð wâs ¹².50%, misdiâgnºsis râþð wâs 6.¹²%; dýðd zººm mºdð PP pârþing diffðrðnþiâl diâgnºsis ºf bðnign ând mâlignânþ lðsiºns ºf þhð cºlºn sðnsiþiviþý þº 9³.75%, â spðcificiþý ºf 95.9²%, misdiâgnºsis râþð wâs 6.²5%, misdiâgnºsis râþð wâs 4.08%; cºnvðnþiºnâl cºlºnºscºpý cºlºrðcþâl diffðrðnþiâl diâgnºsis ºf bðnign ând mâlignânþ lðsiºns sðnsiþiviþý wâs 68.75%, â spðcificiþý ºf 8¹.6³%, ³¹.²5% misdiâgnºsis râþð ºf misdiâgnºsis râþð ºf ¹8.³7%. Cºnclusiºn Undðr NBI ând sþâining pâþþðrns ºf cºlºrðcþâl câncðr ºr ân ðnlârgðd nðºplâsþic lðsiºns hâvð â high diâgnºsþic vâluð, diffðrðnþiâl diâgnºsþic câpâbiliþiðs

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