Release date: 2007-01-23 Narrow-band endoscopy can effectively identify colorectal polyps. Taiwan Su et al reported that narrow-band endoscopy (NBI) can identify neoplastic and non-neoplastic colorectal polyps with no difference in sensitivity, specificity, and accuracy from pigment endoscopy. It is shorter and faster than the endoscopic operation. (Am J Gastroenterol 2006, 101: 2711)
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Ordinary colonoscopy is difficult to distinguish polyp properties. Magnifying endoscopic combined with pigment spray can be effectively identified by observing the shape of the polyp on the surface of the polyp, but the operation is time consuming. NBI clearly shows mucosal vascular structure without spraying pigment, and mucosal vascular network changes are related to the histological properties of polyps.
Su et al. studied the effectiveness of NBI in the diagnosis of colon polyps and compared them with common colonoscopy and pigment endoscopy with 0.2% rouge.
The study included 78 patients. The researchers first observed the lesions under normal colonoscopy, then examined the mucosal capillary network with NBI, and then sprayed 0.2% rouge to further observe the morphology of the mucosal surface. A total of 110 colorectal polyps were found.
The polyps were excised or biopsied to determine the nature of the polyp, and the polyps images were analyzed and diagnosed by two physicians with more than 5 years of colonoscopy experience. The consistency of the diagnostic opinions was expressed by the Kappa value.
Lesions >10 mm or redness, NBI showed brown-enhanced vascular network, and chromoendoscopy revealed that the III-V-shaped fovea was suspected of being a tumorous lesion, otherwise it was considered a non-neoplastic lesion.
The results showed that of the 110 polyps, 65 were adenomas, 40 were hyperplastic polyps, and 5 were adenocarcinomas. The Kappa values ​​for common colonoscopy, chromoendoscopy, and NBI were 0.981, 0.960, and 1.0, respectively.
The diagnosis of the type II and V small concave and the vascular network under NBI was completely consistent with the diagnosis of the two physicians. For the diagnosis of neoplastic polyps, the sensitivity, specificity and accuracy of common colonoscopy were 82.9%, 80.0%, and 81.8%, respectively, which were significantly lower than NBI. The sensitivity, specificity and accuracy of the latter were 95.7%. , 87.5%, 92.7%. The sensitivity, specificity and accuracy of chromoendoscopy were 95.7%, 87.5%, and 92.7%, respectively, and there was no significant difference compared with NBI.
Although the colonoscopy can judge its nature according to the size of the polyp and the surface color, it cannot obtain the morphological characteristics of the surface of the polyp. The pigment-enhanced endoscope compensates for this deficiency, and details of the shape of the small surface of the mucosa can be obtained, and studies have been made to distinguish the nature of the polyp, but it takes time to spray the pigment.
NBI obtains images of mucosal depths of 240 μm, 200 μm and 170 μm with narrow-spectrum light sources with wavelengths of 500 nm, 445 nm and 415 nm, respectively, and the mucosal vascular network is clearly visible due to the maximum absorption of hemoglobin at 415 nm. Brown. The NBI test only needs to switch between the two light sources, but it takes only one second, and there is no need to spray the pigment. The effectiveness of identifying the polyp is the same as that of the pigmented endoscope and higher than that of the common colonoscopy.
â– Comments In view of the fact that common colonoscopy is difficult to identify the nature of colorectal polyps, some new endoscopic techniques are emerging to solve this problem. Narrow-band endoscopy (NBI) improves the endoscope source, eliminating the need for spray dyes to achieve the same diagnostic capabilities as pigmented endoscopes. Convenient and time-saving, it can be a new endoscopy method for identifying the properties of colorectal polyps.
Source: China Medical Tribune 