联动成像结合化学染色技术在大肠侧向发育型肿瘤分型中的应用价值

doi:10.3969/j.issn.1671-7171.2024.01.013

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摘要【目的】探讨联动成像(LCI)结合化学染色技术在大肠侧向发育型肿瘤(LST)分型中的应用价值。【方法】回顾性分析在本院行LCI结合化学染色技术诊断的82例结直肠肿瘤患者(89处病变)的检查图像,对患者病灶表面的小凹形态进行判断,并依据黏膜表面细微腺管开口(Pit)形态分型预测病变性质。对比分析Pit分型与内镜下切除术后病理结果。【结果】 Ⅰ、Ⅱ和Ⅱ-0型诊断多为锯齿状病变(SSP)/增生性息肉(HP)的灵敏度、特异度及准确度分别为55.56%、96.25%、92.13%;Ⅲ_S型单独诊断黏膜下浸润癌浸润深度≥100 mm(SMd)的灵敏度、特异度及准确度分别为20.00%、98.81%、94.38%;Ⅲ_L和Ⅳ型诊断低度异型增生(LGD)/高度异型增生(HGD)的灵敏度、特异度及准确度分别为92.31%、83.33%、89.89%;Ⅴ_n型单独诊断SMd的灵敏度、特异度及准确度分别为40.00%、97.62%、94.38%;Ⅴ_i和Ⅴ_n型诊断黏膜内癌或黏膜下浸润癌但浸润深度＜100 mm(m-SMs)/SMd的灵敏度、特异度及准确度分别为86.67%、97.30%、95.51%;Ⅲ_S型和Ⅴ_n型诊断SMd的灵敏度、特异度及准确度分别为60.00%、96.43%、94.38%。【结论】 LCI结合化学染色术能够对结直肠肿瘤的Pit形态准确完整展现,更易判断肿瘤的病变性质是否为恶性,并可对肿瘤的浸润深度进行预判,其与病理诊断结果的符合率较高。

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关键词 ：结直肠肿瘤/诊断, 结肠镜检查, 免疫组织化学

Abstract：【Objective】 To explore the application of linked color imaging (LCI) combined with chemical staining technology in the classification of laterally spreading tumor of colorectal tumors (LST). 【Methods】 The examination images of 82 patients with colorectal tumors (89 lesions) diagnosed by LCI combined with chemical staining technology in our hospital were retrospectively analyzed, and the morphology of small pits on the surface of the lesions of the patients was evaluated. The characteristics of the lesions was predicted according to the morphological classification of small glandular canal opening (Pit) on the mucosal surface, And the Pit classification was compared with the pathologic results after endoscopic resection. 【Results】 The diagnosis of type Ⅰ, Ⅱ and Ⅱ-0 were mostly serrated lesions (SSP)/hyperplastic polyps (HP). The sensitivity, specificity and accuracy were 55.56%, 96.25% and 92.13%, respectively. The sensitivity, specificity and accuracy of type Ⅲ_S alone in the diagnosis of submucosal invasive carcinoma with an invasion depth ≥100 mm (SMd) were 20.00%, 98.81%, and 94.38%, respectively. The sensitivity, specificity and accuracy of the diagnosis of low-grade dysplasia (LGD)/high-grade dysplasia (HGD) for types Ⅲ_L and Ⅳ were 92.31%, 83.33%, and 89.89%, respectively. The sensitivity, specificity and accuracy of type Ⅴ_n alone in the diagnosis of SMd were 40.00%, 97.62%, and 94.38%, respectively. The sensitivity, specificity and accuracy of type Ⅴ_i and Ⅴ_n in the diagnosis of intramucosal carcinoma or submucosal invasive carcinoma with an invasion depth of less than 100 mm (m-SMs)/SMd were 86.67%, 97.30%, and 95.51%, respectively. The sensitivity, specificity and accuracy of type Ⅲ_S and type Ⅴ_n in the diagnosis of SMd were 60.00%, 96.43%, and 94.38%, respectively. 【Conclusion】 LCI combined with chemical staining can accurately and completely display the Pit shape of rectal mass, which makes it easier to assess whether the mass is neoplasm. And the predicted depth of tumor invasion of the has a high coincidence rate with the pathological diagnosis result.

Key words： Colorectal Neoplasms/DI Colonoscopy Immunohistochemistry

收稿日期: 2022-12-07

中图分类号:

R735.35

通讯作者: *E-mail:ywencui@163.com

引用本文:

秦士钊, 潘晓莉, 尹跃霏, 陈赛龄, 杨文翠. 联动成像结合化学染色技术在大肠侧向发育型肿瘤分型中的应用价值[J]. 医学临床研究, 2024, 41(1): 47-50.
QIN Shizhao, PAN Xiaoli, YIN Yuefei, et al. Application of Linked Color Imaging Combined with Chemical Staining Technique in the Classification of Laterally Spreading Tumor of Large Intestine. JOURNAL OF CLINICAL RESEARCH, 2024, 41(1): 47-50.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2024.01.013 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2024/V41/I1/47

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