窄带成像下JNET分型对结直肠横向扩散肿瘤的诊断价值

Zihua Wang, Jie Yu, Shiying Yang
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引用次数: 0

摘要

目的评价日本窄带成像专家组(JNET)在窄带成像(NBI)下对结直肠癌横向扩散肿瘤的诊断效果。方法回顾性分析170例经NBI和色素染色检测的横向扩散性肿瘤(LST)的临床资料。NBI下的JNET分类用于基于表面模式和血管模式的再诊断。使用PP分类法在颜料染色下观察到凹坑图案(PP)。将结果与内镜切除或手术后的组织学结果进行比较。结果JNET分型和PP分型的诊断敏感性、特异性、阳性预测值、阴性预测值和准确性分别为92.2%和70.3%、82.3%和85.0%、74.7%和72.6%、94.9%和83.5%、85.9%和79.7%,JNET分类和PP分类预测LST浅层入侵深度的一致性分别为6.1%和8.3%,预测深层入侵的一致性则分别为30.8%和4.8%。结论NBI下的JNET分类对预测恶性横向扩散肿瘤是有效的,但对预测肿瘤浸润深度的效果并不理想。PP分类可用于提高诊断困难患者的诊断准确性。关键词:结直肠肿瘤;诊断;横向扩散肿瘤;窄带成像;JNET分类
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Diagnostic value of JNET classification under narrow-band imaging for colorectal laterally spreading tumors
Objective To evaluate the diagnostic efficacy of Japan Narrow Band Imaging Expert Team(JNET) classification under narrow-band imaging (NBI) for colorectal laterally spreading tumors. Methods Data of 170 laterally spreading tumors (LST) detected by NBI and pigment dyeing were reviewed in the retrospective study. JNET classification under NBI was used for rediagnosis based on surface pattern and vessel pattern. Pit pattern(PP) was observed under pigment dyeing using PP classification. The results were compared with histologic results after endoscopic resection or surgery. Results The diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy of JNET classification and PP classification were 92.2% VS 70.3%, 82.3% VS 85.0%, 74.7% VS 72.6%, 94.9% VS 83.5%, 85.9% VS 79.7%, respectively (P=0.159). The consistency rates of JNET classification and PP classification in predicting shallow invasion depth of LST were 6.1% and 8.3% respectively and the consistency rates in predicting deep invasion were 30.8% and 4.8%, respectively. Conclusion JNET classification under NBI is effective in predicting malignant laterally spreading tumors, however, its efficacy in predicting tumor invasion depth is unsatisfied. PP classification can be used to improve the diagnostic accuracy for those with diagnostic difficulty. Key words: Colorectal neoplasms; Diagnosis; Laterally spreading tumor; Narrow-band imaging; JNET classification
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期刊介绍: Chinese Journal of Digestive Endoscopy is a high-level medical academic journal specializing in digestive endoscopy, which was renamed Chinese Journal of Digestive Endoscopy in August 1996 from Endoscopy. Chinese Journal of Digestive Endoscopy mainly reports the leading scientific research results of esophagoscopy, gastroscopy, duodenoscopy, choledochoscopy, laparoscopy, colorectoscopy, small enteroscopy, sigmoidoscopy, etc. and the progress of their equipments and technologies at home and abroad, as well as the clinical diagnosis and treatment experience. The main columns are: treatises, abstracts of treatises, clinical reports, technical exchanges, special case reports and endoscopic complications. The target readers are digestive system diseases and digestive endoscopy workers who are engaged in medical treatment, teaching and scientific research. Chinese Journal of Digestive Endoscopy has been indexed by ISTIC, PKU, CSAD, WPRIM.
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