实用临床医药杂志2025，Vol.29Issue(13)：33-38,6.DOI:10.7619/jcmp.20250853
窄带成像-放大内镜和超声内镜诊断结直肠黏膜下癌的价值及特异性影像特征
Value of narrow band imaging-magnifying endoscopy and endoscopic ultrasonography in diagnosing colorectal submucosal carcinoma and its specific imaging features
摘要
Abstract
Objective To investigate the value of narrow band imaging-magnifying endoscopy(NBI-ME)and endoscopic ultrasonography(EUS)in diagnosing colorectal submucosal carcinoma and to analyze the specific imaging features of submucosal carcinoma.Methods A total of 259 pa-tients with early-stage colorectal cancer were selected as study subjects.All patients underwent NBI-ME and EUS examinations.The consistency between the results of NBI-ME,EUS,and pathological diag-nosis was analyzed.The diagnostic efficacy of NBI-ME,EUS alone,and their combined application for submucosal carcinoma was evaluated.The differences in clinical and imaging features between pa-tients with submucosal carcinoma and intramucosal carcinoma were compared.Results Among 259 patients,203 had intramucosal carcinoma and 56 had submucosal carcinoma.The judgments of tumor infiltration by NBI-ME and EUS showed good consistency with the pathological diagnosis results(Kappa=0.706,0.685,respectively,P＜0.001).The sensitivity and negative predictive value of NBI-ME combined with EUS in diagnosing submucosal carcinoma were higher than those of NBI-ME or EUS alone,while the specificity was lower,with statistically significant differences(P＜0.05).The proportions of patients with submucosal carcinoma having a lesion maximum diameter＞2 cm,easily bleeding lesions,and vascular dilation were 71.43％,46.43％,and 39.29％,respectively,which were higher than those in patients with intramucosal carcinoma(41.87％,28.57％,and 10.34％,respectively)(P＜0.05).Multivariate Logistic regression analysis showed that a lesion maximum diameter＞2 cm,easily bleeding lesions,and vascular dilation were all independent risk factors for submucosal carcinoma(P＜0.05).Conclusion NBI-ME and EUS have certain appli-cation value in diagnosing colorectal submucosal carcinoma and intramucosal carcinoma,and their combined application demonstrates better diagnostic efficacy.Patients with early-stage colorectal cancer having a lesion maximum diameter＞2 cm,easily bleeding lesions,and vascular dilation are at a higher risk of being diagnosed with submucosal carcinoma.关键词
结直肠癌/窄带成像-放大内镜/超声内镜/黏膜下癌/黏膜内癌/血管扩张/肿瘤浸润/影像特征Key words
colorectal cancer/narrow band imaging-magnifying endoscopy/endoscopic ul-trasonography/submucosal carcinoma/intramucosal carcinoma/vascular dilation/tumor infiltra-tion/imaging features分类
医药卫生引用本文复制引用
褚芮,朱敏,刘娟,王拥军..窄带成像-放大内镜和超声内镜诊断结直肠黏膜下癌的价值及特异性影像特征[J].实用临床医药杂志,2025,29(13):33-38,6.基金项目
北京市自然科学基金资助项目(7244321) （7244321）
