田甜 1崔静 1胡桂明 2赵治国 3曹智博 3李浩1
作者信息
- 1. 郑州大学第二附属医院 消化内科,河南 郑州 450000
- 2. 郑州大学第二附属医院 病理科,河南 郑州 450000
- 3. 河南大学附属郑州颐和医院 消化内科,河南 郑州 450000
- 折叠
摘要
Abstract
Objective To investigate the morphological features of colorectal sessile serrated adenoma/polyp (SSA/P) by white light endoscopy (WLE) and narrow band imaging (NBI). Methods A retrospective analysis was made on the morphological characteristics of SSA/P from January 2014 to March 2017, and compared with HP. Results There were 50 cases of SSA/P from 41 patients and 50 cases of HP from 43 patients. SSA/P located in the right colon was more than HP, but the difference was no statistical significance (16 cases vs 14 cases,P > 0.05). SSA/P have 11 cases of Type Is, 21 cases of Type IIa, 16 cases of Type IIb, 2 cases of Type LST, HP have 17 cases of Type Is, 25 cases of Type IIa, 8 cases of Type IIb, there was no significant difference (P > 0.05); SSA/P has more mucus than HP (37 cases vs 11 cases, P < 0.05). In NBI: The proportion of SSA/P with a red mucus cap, indistinctive borders, irregular shape, black dots inside the crypts, Cloud-like surface, Type II-O pit pattern and varicose microvascular vessels were higher than that of HP (P < 0.05). In the differential prediction of SSA/P and HP: Black dots inside the crypts (OR^ : 14.2; 95%CI: 5.8 ~ 34.7) with higher sensitivity, the sensitivity, specificity and accuracy respectively were 80.0%, 78.0%, 79.0%; Type II-O pit pattern (OR^ : 56.0; 95%CI: 17.7 ~ 177.6) with higher specificity, the sensitivity, specificity and accuracy respectively were: 70.0%, 96.0%, 83.0%; Red mucus cap (OR^ : 9.3; 95%CI: 3.8 ~ 22.8) with high specificity, the sensitivity, specificity and accuracy respectively were 64.0%, 80.0%, 74.0%; Cloud-like surface (OR^ : 16.9; 95%CI: 5.7 ~ 50.7) with high specificity and low sensitivity, the sensitivity, specificity and accuracy respectively were: 52.0%, 94.0%, 73.0%. Combining the black dots inside the crypts and Type II-O pit pattern with other endoscopic features of SSA/P could improve the sensitivity and the accuracy in diagnosis prediction. Conclusion The study has confirmed that SSA/P has unique endoscopic features compared with HP in NBI mode. Observing the morphological characteristics of SSA/P with NBI could achieve the purpose of identifying SSA/P and HP. The black dots inside the crypts and Type II-O pit pattern respectively have higher sensitivity and specificity in diagnosis prediction of SSA/P, so we recommend to combine the two indicators with others endoscopic features of SSA/P to identify SSA/P and HP to achieve the purpose of screening SSA/P in colonoscope examination.关键词
无蒂锯齿状腺瘤/息肉/增生性息肉/锯齿状腺瘤/窄带成像模式Key words
sessile serrated adenoma/polyp/hyperplastic polyp/serrated adenoma/narrow band imaging分类
医药卫生
