蓝激光内镜联动成像对结肠侧向发育型肿瘤病灶良、恶性的诊断价值
Value of blue laser endoscopic linkage color imaging in the diagnosis of benign and malignant lesions in colonic laterally spreading tumor
许家珂 1顾庆 1李琴1
作者信息
- 1. 昆山市第二人民医院消化内科,昆山 215300
- 折叠
摘要
目的 探讨蓝激光内镜联动成像在结肠侧向发育型肿瘤(LST)病灶良、恶性诊断中的应用价值.方法 回顾性病例系列研究.回顾性分析2019年6月至2022年6月昆山市第二人民医院诊治的62例结肠LST患者的临床资料.所有患者均采用蓝激光内镜联动成像、白光成像两种模式并结合靛胭脂染色进行结肠镜检查,判断LST病灶的良、恶性,并在内镜下取病灶组织进行病理诊断.采用Kappa检验评估联动成像、白光成像诊断结果与病理诊断结果的一致性;采用受试者工作特征(ROC)曲线评估联动成像与白光成像对LST的诊断效能.结果 62例患者共92个病灶,病理诊断结果示:炎性病灶2个,增生性病灶4个,低级别上皮内瘤变46个,高级别上皮内瘤变37个,黏膜内或黏膜下浸润癌3个.联动成像诊断结果示:I型病灶4个,Ⅱ型病灶39个,Ⅲ型病灶45个,炎性病灶2个,增生性病灶2个;白光成像诊断结果示:I型病灶6个,Ⅱ型病灶40个,Ⅲ型病灶37个,炎性病灶4个,增生性病灶5个.联动成像诊断结果中82个肿瘤性病灶与病理诊断结果一致,4个非肿瘤性病灶与病理诊断结果一致,总符合率为93.48％(86/92),联动成像诊断结果与病理诊断结果具有一致性(Kappa=0.586,P＜0.05);白光成像诊断结果中74个肿瘤性病灶与病理诊断结果一致,3个非肿瘤性病灶与病理诊断结果一致,总符合率为83.70％(77/92),白光成像诊断结果与病理诊断结果具有一致性(Kappa=0.447,P＜0.05);联动成像诊断与病理诊断的一致性高于白光成像.ROC曲线分析显示,联动成像、白光成像用于诊断结肠LST病灶良、恶性的曲线下面积分别为0.810(95％CI:0.715～0.884)、0.681(95％CI:0.575～0.774).结论 蓝激光内镜联动成像诊断结肠LST病灶良、恶性与病理诊断具有较好的一致性,诊断价值较高.
Abstract
Objective To explore the application value of blue laser endoscopic linkage color imaging(LCI)in the diagnosis of benign and malignant lesions in colonic laterally spreading tumor(LST).Methods A retrospective case series study was conducted.The clinical data of 62 patients with colonic LST diagnosed and treated in the Second People's Hospital of Kunshan from June 2019 to June 2022 were retrospectively analyzed.All patients underwent 2 modes of blue laser endoscopic LCI and white light imaging(WLE)combined with indigo blush staining for colonoscopy to determine the benign and malignant LST lesions,and the lesion tissues were taken under the endoscope for pathological diagnosis.Kappa test was used to evaluate the consistency of the diagnostic results of LCI and WLE with pathological diagnosis.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of LCI and WLE for LST.Results A total of 92 LST lesions were detected in 62 patients.Pathological findings showed that among the 92 lesions,there were 2 inflammatory lesions,4 proliferative lesions,46 low-grade intraepithelial neoplasia,37 high-grade intraepithelial neoplasia and 3 infiltrating cancer in mucosa or under mask.The results of LCI of 92 lesions showed that 4 lesions were type 1,39 lesions were type Ⅱ,45 lesions were type Ⅲ,2 lesions were inflammatory and 2 lesions were hyperplastic;the diagnosis results of WLE showed that 6 lesions were type Ⅰ,40 lesions were type Ⅱ,37 lesions were type Ⅲ,4 lesions were inflammatory and 5 lesions were proliferative.Among LCI results,82 neoplastic lesions were consistent with pathological diagnosis,and 4 non-neoplastic lesions were consistent with pathological diagnosis,with a total coincidence rate of 93.48％(86/92);LCI was consistent with pathological diagnosis(Kappa=0.586,P＜0.05).Among WLE results,74 neoplastic lesions were consistent with pathological diagnosis,and 3 non-neoplastic lesions were consistent with pathological diagnosis,with a total coincidence rate of 83.70％(77/92);WLE was consistent with pathological diagnosis(Kappa=0.447,P＜0.05).The consistency of pathological diagnosis with LCI was higher than that with WLE.ROC analysis showed that the area under the curve of LCI and WLE for the diagnosis of benign and malignant lesions in colonic LST was 0.810(95％CI:0.715-0.884)and 0.681(95％CI:0.575-0.774),respectively.Conclusions Blue laser endoscopic LCI has a high consistency with pathological diagnosis in the diagnosis of benign and malignant lesions in colonic LST.It has a high diagnostic value for colonic LST.
关键词
内窥镜检查/结肠侧向发育型肿瘤/联动成像/诊断Key words
Endoscopy/Colonic laterally spreading tumor/Linked color imaging/Diagnosis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据