iscan智能染色与色素内镜技术对结直肠息肉样病变性质的预测分析-predictive analysis of iscan intelligent staining and chromoendoscopy technology for colorectal polypoid lesions.docxVIP

子染色及色素内镜下病变的病理类型，与进行靶向活检或切除的病变最后病理诊断进行对照研究。应用 SPSS 19.0 统计软件进行分析， 计数资料的比较采用 X2 检验，检验水准 P0.05 认为差异有统计学 意义。结果检出结直肠息肉样病变 180 枚，最后病理诊断结果：炎性及 增生性息肉 57 枚，占 31.7 %；腺瘤（管状或绒毛状管状）121 枚， 占 67.2%；癌或局部癌变 2 枚占 1.1%。炎性及增生性病灶为非肿瘤病 变，腺瘤及癌为结直肠肿瘤病变。高分辨率结肠镜 i-Scan 染色对结直 肠肿瘤的诊断敏感度为 86.2%，特异度为 78.9%，准确度为 87.4%，阳性 预测值为 89.8%，阴性预测值为 72.5%。色素内镜对结直肠肿瘤的诊断 敏感度为 90.2%，特异度为 85.9%，准确度为 90.8%，阳性预测值为 93.2 %， 阴性预测值为 80.3%。两者对结直肠肿瘤诊断敏感度、特异度及准确度 比较均无显著性差异(P0.05)。结论 高分辨率放大结肠镜 i-Scan 智能染色与色素内镜检查均能 较准确的预测结直肠息肉样病变的病理类型，与组织病理学诊断有较高 的一致性，两者对结直肠肿瘤实时诊断准确度相当。i-Scan 智能染色更 方便、快捷有较高的实用价值。关键词 i-Scan；色素内镜；结直肠息肉；腺管开口类型(PP)The study of predicting the character of colorectal neoplasms by i-Scan staining and chromoendoscopyAbstractBackground In recent years the incidence and mortality rates of colorectal cancers are higher than before and show a ascending trend. The mortality of colorectal cancer has a closely correlation to clinical stages. At present, there have no first-level preventing measures for colorectal cancer, so early diagnosis and treatment can significantly improve the prognosis of the patients. Most colorectal cancer come from adenomatous polyp and non-adenomatous polyp commonly can not develop into cancer. So early detection and differential diagnosis of the colorectal neoplasm have important clinical significance.Objective To explore the predictive accuracy of diagnosis in differentiation to colorectal neoplasm with i-Scan staining and chromoendoscopy and the diagnosis value of in colorectal neoplasm with i-Scan staining.Methods 108 patients with colorectal neoplasm were collected from January 2014 to November 2014 in our hospital. Altogether 180 neoplasms were found. All of them were diagnosed and treated by colonoscopy and typical cancers were not included. First, the i-Scan,s model of SE(+4), CE(+2) and TE(c) were applied to enlarge and observe the pit pattern. The pit pattern of picture was taken and classified. Then i-Scan was closed and the lesion was stained with 0.2% indigo carmine under the w