摘要
目的探讨日本窄带成像技术专家小组(JNET)分型联合超声内镜(EUS)在结直肠肿瘤性病变浸润深度判断中的临床应用价值。方法回顾性分析2019年10月至2020年10月衡水市人民医院内镜诊疗中心发现的86例结直肠息肉样病变患者的临床资料。所有患者术前均按JNET分型对病变微血管分型,并用EUS评估其浸润深度;与内镜下黏膜切除术、黏膜下剥离术、外科手术所获组织病理结果加以对比;以病理结果为金标准,分析EUS联合JNET分型判定结肠肿瘤性病变浸润深度的可靠性,并与单用JNET分型评估进行对比,一致性分析采用Kappa检验。结果86例患者94个病灶,JNET分型1型与病理诊断增生性息肉/无蒂锯齿状息肉(SSP)的符合率为82.1%(23/28),2A型与病理诊断低级别上皮内瘤变(LGIN)的符合率84.1%(32/38),2B型与病理诊断高级别上皮肉瘤变(HGIN)/黏膜内癌(M)/黏膜下浅层浸润癌(SM-s)的符合率为65.2%(15/23),3型与病理诊断黏膜下深层浸润癌(SM-d)的符合率为61.1%(11/18)。以病理结果为准,EUS联合JNET分型判断病变浸润深度的准确度为97.06%(33/34);一致性检验结果提示,单独JNET分型与病理诊断结果一致性中等(Kappa值0.580,P<0.01),而EUS联合JNET分型与病理诊断结果一致性较高(Kappa值0.940,P<0.01)。结论JNET分型与病理诊断具有一定符合率,但部分亚型符合率仍较低,JNET分型与EUS联合在结直肠肿瘤性病变浸润深度判断中的准确度高于单用JNET分型。
Objective To explore the clinical value of Japan narrow-band imaging expert team(JNET)classification based on magnifying endoscopy with narrow-band imaging(ME-NBI)combined with endoscopic ultrasonography(EUS)in judging the invasion depth of neoplastic lesions.Methods A retrospective analysis was performed on the clinical data of 86 patients with colorectal polypoid lesions diagnosed in Hengshui People's Hospital from October 2019 to October 2020.In all patients,the microvessels of lesions were typed according to JNET classification and evaluated by EUS for the depth of invasion before operation and were compared with pathological diagnosis(as the gold standard)after endoscopic mucosal resection,surgery and submucosal dissection.The reliabilities of EUS combined with JNET classification and JNET classification alone were analyzed in determining the invasion depth of colonic neoplastic lesions.Kappa test was used for consistency analysis between them.Results There were 94 lesions in 86 patients.The coincidence rate of JNET type 1 with pathological diagnosis of hyperplastic polyp/sessile serrated polyp(SSP)was 82.1%(23/28),that of type 2A with pathological diagnosis of low-grade intraepithelial neoplasia(LGIN)was 84.1%(32/38),that of type 2B and pathological diagnosis of high grade intraepithelial neoplasia(HGIN)/intramucosal carcinoma(M)/superficial submucosal invasive carcinoma(SM-s)was 65.2%(15/23),and that of type 3 and pathological diagnosis of deep submucosal invasive carcinoma(SM-d)was 61.1%(11/18).The accuracy of EUS combined with JNET was 97.06%(33/34)in determining the depth of lesion infiltration.The consistency test showed that the consistency between JNET classification alone and pathological diagnosis was medium(Kappa=0.580,P<0.01),while,there was a high consistency between EUS combined with JNET classification and pathological diagnosis(Kappa=0.940,P<0.01).Conclusions There is a certain coincidence rate between NET classification and pathological diagnosis,but that of some subtypes is still low.The ac
作者
杨彬
田志颖
王丽华
YANG Bin;TIAN Zhi-ying;WANG Li-hua(Department of Gastroenterology,Hengshui People's Hospital,Hengshui,Hebei 053000,China)
出处
《中国临床研究》
CAS
2022年第1期66-69,共4页
Chinese Journal of Clinical Research
基金
河北省2019年度医学科学研究课题计划(20191759)。
关键词
结直肠肿瘤性病变
窄带成像技术
超声内镜
日本窄带成像技术专家小组分型
Colorectal neoplastic lesions
Narrow-band imaging
Endoscopic ultrasonography
Japan narrow-band imaging expert team classification
