JNET分型与Pit Pattern分型对结直肠肿瘤性病变的诊断价值比较研究

Comparative Study on the Diagnostic Efficacy of the Japan Narrow-Band-Imaging Expert Team Classification and Pit Pattern Classification for Colorectal Neoplastic Lesions

摘要: 目的：评估并比较窄带成像放大内镜(ME-NBI)下应用JNET分型与Pit pattern分型对结直肠肿瘤性病变的诊断价值，更好地指导内镜下诊治。方法：收集2019.01.01至2021.12.31接受ME-NBI模式结肠镜检查并行病理检查的201例患者，共216处病变，将依据JNET分型与Pit pattern分型的内镜诊断结果与病理分型结果进行比较。结果：在ME-NBI下JNET分型与Pit pattern分型诊断结直肠肿瘤性病变的敏感度、特异度、阳性预测值、阴性预测值分别为100%、20.83%、90.05%、100%、91.20%和98.96%、54.17%、94.53%、86.67%、93.98%，两者在诊断准确性上差异具有统计学意义(χ2 = 99.116, P < 0.001)。同时，在诊断具有内镜治疗指征的早期结直肠癌时JNET分型、Pit pattern分型的敏感度、特异度、阳性预测值、阴性预测值分别为71.43%、76.05%、46.67%、90.07%、75.00%和81.63%、93.41%、78.43%、94.55%、90.74%，两者在诊断准确性上差异具有统计学意义(χ2 = 14.400, P < 0.001)。结论：ME-NBI下先采用JNET分型可发现更多的肿瘤性病变，再利用Pit pattern提高诊断肿瘤性病变的准确性，提升内镜诊治质量。

Abstract: Objective: To evaluate and compare the diagnostic efficacy of the Japan Narrow-Band-Imaging Ex-pert Team (JNET) classification and Pit pattern classification in the diagnosis of colorectal neoplastic lesions under magnifying endoscopy with narrow-band imaging (ME-NBI), so as to better guide the endoscopic diagnosis and treatment. Methods: A total of 216 lesions in 201 patients who underwent colonoscopy in ME-NBI mode and pathological examination from January 1, 2019 to December 31, 2019 were collected, the endoscopic diagnosis results based on JNET classification and Pit pattern classification were compared with actual pathological results. Results: The sensitivity, specificity, positive predictive value, and negative predictive value of JNET classification and Pit pattern classi-fication in the diagnosis of colorectal neoplastic lesions under ME-NBI were 100%, 20.83%, 90.05%, 100%, 91.20% and 98.96%, 54.17%, 94.53%, 86.67%, 93.98%, respectively. The difference in di-agnostic accuracy between the two was statistically significant (χ2 = 99.116, P < 0.001). Meanwhile, the sensitivity, specificity, positive predictive value, and negative predictive value of JNET classifica-tion and Pit pattern classification in the diagnosis of early colorectal cancer with indications for en-doscopic treatment were 71.43%, 76.05%, 46.67%, 90.07%, 75.00% and 81.63%, 93.41%, 78.43%, 94.55%, 90.74%, respectively, with statistically significant differences in diagnostic accuracy be-tween the two (χ2 = 14.400, P < 0.001). Conclusion: Under ME-NBI, JNET classification can be used to find more neoplastic lesions, and then Pit pattern can be used to improve the accuracy of diagnosis of neoplastic lesions, which can improve the quality of endoscopic diagnosis and treatment.