窄带色素内镜诊治结直肠广基隆起性病变价值研究.docVIP

窄带色素内镜诊治结直肠广基隆起性病变价值研究 　　【摘要】 目的：评价窄带色素内镜（NBI）诊治结直肠广基隆起性病变的临床价值。方法：利用NBI观察结直肠广基隆起病灶形态学（腺管开口pit分型及微血管形态），然后通过内镜黏膜切除术（EMR）切除病灶，与术前对比，评价NBI判断结直肠广基隆起性病变性质的准确性以及内镜微创治疗中的作用。结果：31例病变均予EMR切除，3例Ⅱa+Ⅱc病变予EPMR切除。术后病理提示增生性息肉4个，管状腺瘤或管状绒毛状腺瘤伴低级别上皮内瘤变（LGD）14个（41.2%，14/34），管状腺瘤或管状绒毛状腺瘤伴高级别上皮内瘤变（HGD）12个（35.3%，12/34），黏膜内癌2个（5.9%，2/34），黏膜下癌2个（5.9%，2/34），其中黏膜下癌转外科手术治疗，但术后病变肠段未发现残留肿瘤组织残留和淋巴结转移；34例病变组织学治愈率为94.1%（32/34），整块切除率 91.2%（31/34），NBI预判病变性质及浸润深度的准确率为94.1%（32/34）。结论：应用NBI能较准确判断结直肠广基隆起型病灶的性质及浸润深度，从而可进一步指导内镜微创治疗。 　　【关键词】 结直肠肿瘤； 内镜黏膜切除术； 窄谱内镜 　　中图分类号 R735.3 文献标识码 B 文章编号 1674-6805（2015）13-0017-03 　　Clinical Valve on Narrow Band Imaging for Colorectal Flat Tumors/LI Qing-feng，LIU Zhao-zhou，QIU Li-hua.//Chinese and Foreign Medical Research，2015，13（13）：17-19 　　【Abstract】 Objective：To investigate the clinical effect on narrow band imaging（NBI） for colorectal flat tumors.Method：The association of morphology （Pit Pattern and Capillary Pattern） of colorectal flat lesions resected by EMR with histopathology was observed and the accuracy of estimation of invasive depth by NBI was evaluated.Result：31 cases of lesions were resected by EMR，3 cases of type Ⅱa+Ⅱc were received EPMR.Histopathological confirmed that the lesions were Hyperplastic polyp（n=4），tubular adenoma or tubular villous adenoma with low level intraepithelial neoplasia（LGD，n=14，41.2%，14/34），tubular adenoma or tubular villous adenoma with high level intraepithelial neoplasia（LGD，n=12，35.3%，12/34），mucosal carcinoma（n=2，5.9%，2/34），submucosal carcinoma（n=2，5.9%，2/34）.Submucosal carcinoma were resected by surgery operation and both the lateral and basal margins of the specimens were free of tumor cells and without surrounding lymph node metastasis.The results of the 34 lesions disposable en-bloc resection rate was 91.2%（31/34），histological curative resection rate was 94.1%（32/34）.The accuracy of estimating invasive depth by NBI was 94.1%（32/34）.Conclusion：Colorectal lesions of colorectal flat type can accurately be determined by NB