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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:选取常规肠镜镜检的70例(114处病灶)进行研究,采用NBI观察息肉表面微血管结构(CP),染色放大模式下观察息肉表面腺管的开口形态(PP),以病理结果作为金标准。结果:NBI正确诊断增生性、炎症病变增生38例(80.85%)、腺瘤35例(68.63%)、腺癌14例(87.50%),与病理诊断的一致性kappa值为0.619,P<0.001;染色放大模式下正确诊断增生性、炎症病变增生38例(80.85%)、腺瘤36例(70.59%)、腺癌14例(87.50%),与病理诊断的一致性kappa值为0.632,P<0.001。鉴别诊断大肠病灶良恶性的价值:NIB检查CP分型的灵敏度为87.50%、特异度为93.88%,染色放大模式下PP分型的灵敏度为93.75%、特异度为95.92%,常规肠镜的灵敏度为68.75%、特异度为81.63%。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。
Objective: To explore the differential diagnosis of colorectal neoplasms or non-neoplastic lesions by narrow band imaging (NBI) and staining amplification. Methods: Seventy patients (114 lesions) underwent routine enteroscopy were studied. The surface microvascular structure (CP) of polyp was observed with NBI. The morphology of the open duct (PP) was observed under the magnification mode. The pathological results were taken as gold standard. RESULTS: NBI correctly diagnosed hyperplastic lesions with 38.8% (80.85%) of inflammatory lesions, 35 (68.63%) adenomas and 14 (87.50%) adenocarcinomas. The concordance kappa value with pathological diagnosis was 0.619, P <0.001 (80.85%), adenoma in 36 cases (70.59%), adenocarcinoma in 14 cases (87.50%), consistent with the pathological diagnosis kappa value of 0.632, P <0.001. The differential diagnostic value of benign and malignant colorectal lesions: NIB examination of the sensitivity of the CP typing was 87.50%, the specificity of 93.88%, PP magnification mode staining sensitivity of 93.75%, a specificity of 95.92%, the sensitivity of conventional colonoscopy 68.75%, the specificity was 81.63%. Conclusions: NBI and staining amplification mode have high diagnostic value for colorectal neoplasms or non-neoplastic lesions, and their differential diagnostic ability is superior to conventional colonoscopy.