结肠多体中尼斯分类和组织病理学之间的一致性:三级中心体验的三级中心体验
Andrea C Buitrago-Tamayo1, Carlos E Lombo-Moreno2, Valentina Ursida3
1Gastroenterologist, Pontificia Universidad Javeriana, Bogotá, Colombia.
Therapeutic advances in gastrointestinal endoscopy
|February 23, 2024
概括
狭带成像国际结直肠内镜 (NICE) 分类显示,结直肠多体与组织病理学相对适度一致. NICE III为诊断深部粘膜下侵袭性癌症提供了高特异性,特别是在较大的或左侧的息肉中.
科学领域:
- 胃肠病学 胃肠病学
- 内镜成像系统的成像
- 结肠直肠癌查 结肠直肠癌查
背景情况:
- 狭带成像国际结直肠内镜 (NICE) 分类有潜力减少在结直肠多评估中对组织病理学的需要.
- 地方和区域验证研究对于确认NICE分类的实用性至关重要.
研究的目的:
- 评估NICE分类与组织病理学在分化结直肠多瘤中的一致性.
- 评估NICE分类的诊断性能,特别是NICE III,用于识别深部粘膜下侵袭性癌症 (DSIC).
主要方法:
- 进行了一项前性分析研究,涉及135名患者的238个结肠直肠多.
- 使用加权的kappa统计数据来评估NICE I,II,III分类和组织病理学 (超塑性息肉,腺瘤,DSIC) 之间的一致性.
- 诊断性表现指标,包括灵敏度和特异性,用于NICE III和NICE I-II,并对小息肉大小和位置进行亚组分析.
主要成果:
- 在NICE分类和组织病理学之间观察到相当到中等的一致性 (加权kappa 0.36-0.43).
- 与腺瘤/HP相比,NICE分类显示了DSIC诊断的高灵敏度 (90.9%) 和特异性 (99.1%).
- 对DSIC诊断的特异性仍然很高 (95%) 10毫米的息肉和位于左结肠的息肉.
结论:
- 虽然NICE和组织病理学之间的整体一致性是不理想的,但NICE III对DSIC检测具有很好的特异性.
- 被归类为NICE III的息肉需要立即进行组织病理学评估和适当的后续治疗.
- 该研究建议在拉丁美洲的胃肠病学部门进行正式的窄带成像培训,强调其对较大和左侧多的操作特征.
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