i-Scan电子染色技术在筛查右半结肠息肉样病变中的应用价值

Diagnostic value of i-Scan high definition endoscopy for screening polypoid lesions in right hemicolon

摘要:

目的 探讨内镜i-Scan模式在右半结肠息肉样病变检出中的价值。 方法 采用前瞻性、随机、自身对照的研究方法，以2015年1月至12月间在北京世纪坛医院接受结肠镜检查的200例患者为研究对象，常规观察右半结肠后，分别采用白光模式（白光组，93例）及i-Scan模式（i-Scan组，96例）再次观察右半结肠，比较两组右半结肠息肉及腺瘤的检出情况。 结果 两次检查i-Scan组人均息肉检出数显著多于白光组（1.469比1.011，P=0.028），第2次退镜多检出息肉的患者多于白光组[37.5％（36/96）比22.6％（21/93），P=0.025]，能够检出更多直径＜5 mm的息肉[84.0％（42/50）比58.3％（14/24），P=0.016]。i-Scan组人均腺瘤检出数量多于白光组（0.979比0.624，P=0.039），第2次退镜多检出腺瘤的患者多于白光组[24.0％（23/96）比11.8％（11/93），P=0.030]，两组多检出腺瘤的大小、部位、形态差异无统计学意义（P＞0.05）。i-Scan组与白光组的息肉检出率分别为61.5％（59/96）、48.4％（45/93）（P=0.071），腺瘤检出率分别为47.9％（46/96）、35.5％（33/93）（P=0.083）。 结论 内镜i-Scan模式可增加右半结肠息肉及腺瘤的检出，并提高多发息肉及腺瘤患者息肉样病变的检出及小息肉（直径＜5 mm）的检出。

Abstract:

Objective To explore the diagnostic value of the i-Scan for detection of polypoid lesions in right hemicolon during colonoscopy. Methods A total of 200 patients who underwent colonoscopy in Beijing Shijitan Hospital from January 2015 to December 2015 were enrolled. After completion of the first colonoscopy in right hemicolon， a second withdrawal was performed， using white light mode （white light group， n=93） and i-Scan mode （i-scan group， n=96） to detect polypoid lesions in the proximal colon. The detection rates of polyp and adenoma were compared between the two groups. Results During the twice withdrawal， compared with white light group， more polyps and adenomas were detected in i-Scan group （1.469 VS 1.011， P=0.028； 0.979 VS 0.624，P=0.039）. The proportion of patients with more polyps and adenomas in the i-Scan group was significantly higher than that in the white light group [37.5％ （36/96） VS 22.6％ （21/93）， P=0.025； 24.0％ （23/96） VS 11.8％ （11/93），P=0.030]. i-Scan mode detected more small polyps with diameter＜5 mm[84.0％ （42/50） VS 58.3％ （14/24），P=0.016]. However， there were no differences between the two groups in the size， location， and morphology of the detected adenomas （all P＞0.05）. The polyp detection rates of the i-Scan group and white light group were 61.5％ （59/96） and 48.4％ （45/93）， respectively （P=0.071）， and the adenoma detection rates were 47.9％ （46/96） and 35.5％ （33/93）， respectively （P=0.083）. Conclusion I-Scan mode can increase the detection rate of polyps and adenomas in right hemicolon， and improve detection of polypoid lesions and small polyps in patients with multiple polyps and adenomas.