用内镜检查大型非形结直肠多
Sunil Gupta1,2, Tony He1, Jeffrey D Mosko1
1Division of Gastroenterology, Department of Medicine, The Center for Advanced Therapeutic Endoscopy and Endoscopic Oncology, St. Michael's Hospital, Toronto, ON M5B 1W8, Canada.
准确的光学评估大型非形结肠直肠多 (LNPCPs) 对于识别T1结肠直肠癌 (CRC) 至关重要. 这允许适当的内镜切除策略,可能实现表面T1CRC的治愈结果.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡外科手術 內視鏡外科手術
- 在瘤学瘤学.
背景情况:
- 大型非形结直肠多体 (LNPCPs) 占结直肠多体的约1%.
- 这些息肉携带着下侵袭性癌症 (T1结直肠癌) 的风险.
- 如果符合特定的组织学标准,可以通过内镜治疗地切除表面T1CRC.
研究的目的:
- 审查用于预测LNPCP中T1CRC风险的关键光学评估组件.
- 讨论LNPCPs的内镜切除策略.
- 突出影响切除方式选择的因素.
主要方法:
- 对LNPCP的光学评估技术的审查.
- 形态学的分析 (巴黎,LST分类).
- 评估表面孔/血管模式 (JNET,Kudo分类) 和损伤位置.
主要成果:
- 光学评估有助于预测T1 CRC风险.
- 形态,表面图案和位置是关键的预测因素.
- 像内镜下粘膜切割和内镜粘膜切除这样的内镜切除方式是可行的选择.
结论:
- 彻底的光学评估对于选择LNPCPs最佳内镜切除策略至关重要.
- 诸如病变的可访问性和下纤维化等因素影响切除方式的选择.
- 内镜切除可以为具有表面T1CRC的选定的LNPCPs实现治愈结果.
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