目的: 本研究旨在研究联动成像（linked color imaging,LCI）对比窄带成像（narrow-band imaging,NBI）在结直肠微小锯齿状病变诊断中的价值。方法: 本项目为前瞻性研究。选取2024年1月―7月在皖南医学院第二附属医院接受结肠镜检查的664例患者,随机分为LCI组和NBI组。比较两组在结直肠微小息肉数量的检出率、肠道各部位息肉检出率,息肉不同山田分型检出率并进行相应病理诊断结果对比。结果: LCI组微小息肉的总检出率高于NBI组,右半结肠微小息肉检出率LCI组高于NBI组;尤其在山田Ⅰ型病变的检出率上,LCI组显著高于NBI组。病理学结果方面,LCI组检出的炎性息肉和无蒂锯齿状病变数量均高于NBI组。结论: LCI技术在提高结直肠微小息肉,尤其是右半结肠微小息肉和无蒂锯齿状病变的检出率方面具有显著优势,对预防结直肠癌的发生具有重要的临床意义。
Abstract
Objective This study aims to investigate the value of link color imaging (LCI) compared with Narrow Band Imaging (NBI) in the diagnosis of minute serrated lesions in the colon and rectum. Methods A prospective study was conducted from January to July 2024, including 664 patients who underwent colonoscopy at the Second Affiliated Hospital of Wannan Medical College. Patients were randomly divided into the LCI group and the NBI group. The study compared the detection rates of minute polyps in the colon and rectum, the detection rates of polyps in different parts of the intestine, the detection rates of different Sanada typing of polyps, and the corresponding pathological comparison between the two groups. Results The overall detection rate of minute polyps in the LCI group was higher than that in the NBI group (P<0.05), and the detection rate of minute polyps in the right hemicolon was higher in the LCI group than in the NBI group; especially in the detection rate of Sanada type I lesions, the LCI group was significantly higher than the NBI group (P<0.001). In terms of pathological results, the number of inflammatory polyps and sessile serrated lesions detected in the LCI group was higher than that in the NBI group (P<0.05). Conclusion LCI technology has a significant advantage in improving the detection rate of minute polyps in the colon and rectum, especially minute polyps in the right half of the colon and sessile serrated lesions, which has important clinical significance for the prevention of colorectal cancer.
关键词
联动成像 /
窄带成像 /
结肠镜 /
微小息肉 /
无蒂锯齿状病变
Key words
link color imaging /
narrow band imaging /
colonoscopy /
small polyps /
sessile serrated adenomas
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参考文献
[1] BRAY F, LAVERSANNE M, SUNG H, et al.Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2024, 4(3) : 229-263.
[2] 姜林燕, 张科未, 周峰, 等. 结直肠息肉切除术中再次完成结肠镜检查对减少息肉漏诊的价值[J]. 胃肠病学, 2023, 28(08) : 462-466.
[3] 禹蓉, 董卫国, 田山, 等. 不同病理类型结直肠息肉癌变的临床研究进展[J]. 中国全科医学, 2023, 26(14) : 1790-1794.
[4] 郑阔, 高显华, 白辰光, 等. 早发性与晚发性结直肠癌的发病趋势、临床病理特征、治疗及预后的对比研究: 一项单中心2000—2021年间34 067例患者的回顾性队列研究[J]. 中华胃肠外科杂志, 2023, 26(01) : 93-101.
[5] LI J, ZHANG D, WEI Y, et al. Colorectal Sessile Serrated Lesion Detection Using Linked Color Imaging: A Multicenter, Parallel Randomized Controlled Trial[J]. Clin Gastroenterol Hepatol, 2023 , 21 (2) : 328-336. e2.
[6] 殷旻皓, 朱宏. 人工智能辅助窄带成像技术诊断结直肠平坦型病变的临床研究[J]. 现代消化及介入诊疗, 2024, 29(03) : 361-367.
[7] GROZA AL, MIUTESCU B, TEFAS C, et al.Evaluating the Efficacy of Resect-and-Discard and Resect-and-Retrieve Strategies for Diminutive Colonic Polyps[J]. Life (Basel) , 2024 , 14(4) : 532.
[8] TORO DH, MIRZA ZT, BÁEZ F, et al. Increased Prevalence of Advanced Histologic Features in Small and Diminutive Polyps in Patients Undergoing Surveillance and Diagnostic Colonoscopy[J]. P R Health Sci J, 2023 , 42(2) : 139-145.
[9] ZHANG J, SUN H, XIONG F, et al.The absolute number of small and diminutive adenomas with high-grade dysplasia is substantially higher compared with large adenomas: a retrospective pooled study[J]. Front Oncol, 2024 , 14: 1294745.
[10] 白成, 侯晓佳, 张旭艳, 等. 黑色先端帽联合窄带光成像在结肠镜检查中的作用[J]. 中华消化内镜杂志, 2020, 37(11) : 829-833.
[11] SAITO M, KOIKE T, OHARA Y, et al.Linked-color imaging may help improve the visibility of superficial Barrett’s esophageal adenocarcinoma by increasing the color difference[J]. Intern Med, 2021, 60: 3351-3358.
[12] 赵鑫, 窦利州, 张月明, 等. 结直肠锯齿状腺瘤的临床特征及恶变影响因素分析[J]. 中华胃肠外科杂志, 2021, 24(01) : 75-80.
[13] TAKEDA T, ASAOKA D, NOJIRI S, et al.Linked color imaging and the Kyoto classification of gastritis: evaluation of visibility and inter-rater reliability[J]. Digestion, 2020, 101: 598-607.
[14] YOSHIDA N, DRAGANOV PV, JOHN S, et al.Comparison of LED and LASER Colonoscopy About Linked Color Imaging and Blue Laser/Light Imaging of Colorectal Tumors in a Multinational Study[J]. Dig Dis Sci, 2023 , 68(10) : 3943-3952.
[15] 许家珂, 顾庆, 李琴. 蓝激光内镜联动成像对结肠侧向发育型肿瘤病灶良、恶性的诊断价值[J]. 肿瘤研究与临床, 2024, 36(05) : 347-350.
[16] 林堃, 方军, 王帆, 等. 结直肠无蒂锯齿状病变癌变的内镜及通路改变[J]. 中华消化内镜杂志, 2023, 40(09) : 759-764.
[17] RADAELLI F.How to optimize the detection of serrated lesions: old tools for a new story?[J]. Endoscopy, 2023, 55(6) : 555-556.
[18] TORO DH, MIRZA ZT, BÁEZ F, et al. Increased Prevalence of Advanced Histologic Features in Small and Diminutive Polyps in Patients Undergoing Surveillance and Diagnostic Colonoscopy[J]. P R Health Sci J, 2023 , 42(2) : 139-145.
基金
国家自然科学基金面上项目“多部分级靶向诱饵外泌体递释系统瘤内级联免疫激活克服三阴性乳腺癌耐药的研究”（82373294）;芜湖市科技局课题项目“SMYD2通过组蛋白甲基化修饰激活EVI2A表达促进免疫逃逸诱导胰腺癌化疗耐药的机制研究”（2023jc24）;芜湖市卫健委科研项目“PDK4抑制铁死亡诱导胰腺癌吉西他滨耐药的机制研究”（WHWJ2023y013）
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