PDF(Pubmed)
Abstract：
UNASSIGNED: Small rectosigmoid colorectal polyps (<10 mm) are prevalent, with a low prevalence of advanced neoplastic lesions. The \"diagnose-and-leave\" strategy, employing narrow band imaging (NBI), is gaining popularity for its safety and cost-effectiveness by reducing polypectomy complications and minimizing histopathology expenses. This study assessed the diagnostic efficacy of NBI with dual focus (DF) magnification for real-time neoplastic prediction of rectosigmoid polyps and explored the feasibility of implementing this strategy in Vietnam.
UNASSIGNED: In a prospective single-center study, 307 rectosigmoid polyps from 245 patients were analyzed using three consecutive endoscopic modes: white light endoscopy (WLE), NBI, and NBI-DF. Endoscopists assessed polyps for size, location, macroscopic shape, optical diagnosis, and confidence levels before histopathological evaluation. High confidence was assigned when the polyp exhibited all features of a single histology type. Predictions were compared with final histopathology results.
UNASSIGNED: Of the total, 237 (77.2%) were diminutive (≤5 mm) polyps, and 18 (5.8%) were advanced neoplastic lesions. WLE + NBI and WLE + NBI + NBI-DF exhibited significantly higher accuracy compared to WLE (88.6% and 90.2% vs 74.2%, P < 0.01). For diminutive polyps, the DF mode significantly increased the rate of high-confidence optical diagnoses (89.1% vs 94.9%, P < 0.001). WLE + NBI + NBI-DF demonstrated high sensitivity (90.1%), specificity (95.5%), and negative predictive value (93.4%) in high-confidence predictions, enabling the implementation of the \"diagnose-and-leave\" strategy. This approach would have reduced 58.2% of unnecessary polypectomies without missing any advanced neoplastic lesions.
UNASSIGNED: NBI and DF modes provide accurate neoplastic predictions for rectosigmoid polyps. For diminutive polyps, DF magnification improves the confidence level of the optical diagnosis, allowing the safe implementation of the \"diagnose-and-leave\" strategy.
UNASSIGNED: In a prospective single-center study, 307 rectosigmoid polyps from 245 patients were analyzed using three consecutive endoscopic modes: white light endoscopy (WLE), NBI, and NBI-DF. Endoscopists assessed polyps for size, location, macroscopic shape, optical diagnosis, and confidence levels before histopathological evaluation. High confidence was assigned when the polyp exhibited all features of a single histology type. Predictions were compared with final histopathology results.
UNASSIGNED: Of the total, 237 (77.2%) were diminutive (≤5 mm) polyps, and 18 (5.8%) were advanced neoplastic lesions. WLE + NBI and WLE + NBI + NBI-DF exhibited significantly higher accuracy compared to WLE (88.6% and 90.2% vs 74.2%, P < 0.01). For diminutive polyps, the DF mode significantly increased the rate of high-confidence optical diagnoses (89.1% vs 94.9%, P < 0.001). WLE + NBI + NBI-DF demonstrated high sensitivity (90.1%), specificity (95.5%), and negative predictive value (93.4%) in high-confidence predictions, enabling the implementation of the \"diagnose-and-leave\" strategy. This approach would have reduced 58.2% of unnecessary polypectomies without missing any advanced neoplastic lesions.
UNASSIGNED: NBI and DF modes provide accurate neoplastic predictions for rectosigmoid polyps. For diminutive polyps, DF magnification improves the confidence level of the optical diagnosis, allowing the safe implementation of the \"diagnose-and-leave\" strategy.
摘要：
■直肠乙状结肠小息肉（<10毫米）普遍存在，晚期肿瘤病变的患病率较低。“诊断并离开”策略，采用窄带成像(NBI)，通过减少息肉切除术并发症和最小化组织病理学费用，其安全性和成本效益越来越受欢迎。这项研究评估了具有双焦点（DF）放大倍数的NBI对直肠乙状结肠息肉的实时肿瘤预测的诊断功效，并探讨了在越南实施该策略的可行性。
■在一项前瞻性单中心研究中，使用三种连续的内窥镜模式对245例患者的307例直肠乙状结肠息肉进行了分析：白光内窥镜（WLE），NBI,NBI-DF内镜医师评估息肉的大小，location,宏观形状，光学诊断,和组织病理学评估前的置信水平。当息肉表现出单一组织学类型的所有特征时，分配高置信度。将预测与最终组织病理学结果进行比较。
■在总数中，237例（77.2%）为小（≤5mm）息肉，18例(5.8%)为晚期肿瘤性病变。与WLE相比，WLE+NBI和WLE+NBI+NBI-DF表现出更高的准确性（88.6%和90.2%vs74.2%，P<0.01)。对于小型息肉，DF模式显著提高了高置信度光学诊断率(89.1%vs94.9%，P<0.001)。WLE+NBI+NBI-DF表现出高灵敏度（90.1%），特异性（95.5%），高置信度预测中的阴性预测值(93.4%)，启用“诊断并离开”策略的实施。这种方法可以减少58.2％的不必要的息肉切除术，而不会错过任何晚期肿瘤病变。
■NBI和DF模式为直肠乙状结肠息肉提供了准确的肿瘤预测。对于小型息肉，DF放大率提高了光学诊断的置信水平，允许安全实施“诊断并离开”策略。
■在一项前瞻性单中心研究中，使用三种连续的内窥镜模式对245例患者的307例直肠乙状结肠息肉进行了分析：白光内窥镜（WLE），NBI,NBI-DF内镜医师评估息肉的大小，location,宏观形状，光学诊断,和组织病理学评估前的置信水平。当息肉表现出单一组织学类型的所有特征时，分配高置信度。将预测与最终组织病理学结果进行比较。
■在总数中，237例（77.2%）为小（≤5mm）息肉，18例(5.8%)为晚期肿瘤性病变。与WLE相比，WLE+NBI和WLE+NBI+NBI-DF表现出更高的准确性（88.6%和90.2%vs74.2%，P<0.01)。对于小型息肉，DF模式显著提高了高置信度光学诊断率(89.1%vs94.9%，P<0.001)。WLE+NBI+NBI-DF表现出高灵敏度（90.1%），特异性（95.5%），高置信度预测中的阴性预测值(93.4%)，启用“诊断并离开”策略的实施。这种方法可以减少58.2％的不必要的息肉切除术，而不会错过任何晚期肿瘤病变。
■NBI和DF模式为直肠乙状结肠息肉提供了准确的肿瘤预测。对于小型息肉，DF放大率提高了光学诊断的置信水平，允许安全实施“诊断并离开”策略。
