Acetic Acid Spray Combined with Narrow-band Imaging Endoscopy in Diagnosis of Early Colorectal Cancer and Precancerous Lesions / 胃肠病学

ABSTRACT

BacKground:Acetic acid spray combined with narrow-band imaging ( NBI ) endoscopy can improve the earIy diagnosis of coIorectaI cancer and precancerous Iesions. Aims:To assess the vaIue of acetic acid spray combined with NBI in diagnosis of earIy coIorectaI cancer and precancerous Iesions. Methods:A totaI of 236 coIorectaI cancer and precancerous Iesions in 180 patients detected by screening endoscopy from Nov. 2011 to JuIy 2013 were enroIIed in this study. Acetic acid spray combined with NBI( combination group),singIe NBI,and indigo carmine staining were used to observe pit pattern,bIood capiIIary forms of the Iesion and mucosa whitening time,and vaIues of the three methods in diagnosis of earIy coIorectaI cancer and precancerous Iesions were evaIuated. Results:Image cIarity of pit pattern in combination group was significantIy improved than that in NBI group and indigo carmine group(χ2 =15. 113,P=0. 000;χ2 =6. 128,P=0. 013);image cIarity of bIood capiIIary forms in combination group was significantIy improved than that in NBI group(χ2 =7. 384,P =0. 007). The overaII coincidence rates of diagnosis in combination group,NBI group, indigo carmine group were 91. 9%,89. 0%,86. 9%,respectiveIy. The diagnosis rate of pit pattern in combination group was significantIy higher than that in NBI group(χ2 =4. 490,P=0. 034),but no significant difference in bIood capiIIary forms was found between combination group and NBI group. The sensitivity of type Ⅲ,Ⅳ,Ⅴ pit pattern,type Ⅱ,ⅢbIood capiIIary forms,mucosa whitening time <30 seconds for diagnosis of coIorectaI cancer and precancerous Iesions in combination group were 94. 0%,92. 8%,92. 2%,respectiveIy,the specificity were 87. 4%,88. 1%,88. 0%, respectiveIy,and the accuracy were 91. 5%,91. 1%,90. 7%,respectiveIy. The sensitivity,specificity and accuracy of type ⅤN or highIy irreguIar ⅤI pit pattern,type ⅢB bIood capiIIary forms and mucosa whitening time 0-5 seconds for predicting invasive carcinoma in combination group were aII quite weII. Conclusions:Acetic acid spray combined with NBI can cIearIy show the pit pattern and bIood capiIIary forms of earIy coIorectaI cancer and precancerous Iesions,and is fairIy consistent with the pathoIogicaI diagnosis. It is heIpfuI for diagnosing the nature of Iesion and depth of invasion.