INTESTINE Vol.9 No.2(3-2)


特集名 拡大内視鏡の最前線
題名 拡大内視鏡による質診断 (2) 通常内視鏡との比較,色素内視鏡とNarrow Band lmaging (NBI) system
発刊年月 2005年 03月
著者 町田 浩久 大阪市立大学大学院医学研究科消化器器官制御内科学
著者 佐野 寧 国立がんセンター東病院消化器内科内視鏡部
著者 傳 光義 国立がんセンター東病院消化器内科内視鏡部
著者 吉田 茂昭 国立がんセンター東病院消化器内科内視鏡部
【 要旨 】 要旨はありません。
Theme The front line of magnifying endoscopy and pit pattern diagnosis -- Now and future
Title Magnifying chromoendoscopy and optical / digital chromoendoscopy using NBI system
Author Hirohisa Machida Department of Gastroenterology, Graduate School of Medicine, Osaka City University
Author Yasushi Sano Division of Gastrointestinal Oncology and Endoscopy, National Cancer Center Hospital East
Author Fu Kuang-I Division of Gastrointestinal Oncology and Endoscopy, National Cancer Center Hospital East
Author Shigeaki Yoshida Division of Gastrointestinal Oncology and Endoscopy, National Cancer Center Hospital East
[ Summary ] Aim : Differential diagnosis between non-neoplastic and neoplastic lesions is very important during colonoscopy. We estimated the reliability of indigo carmine dye spraying, with and without magnification, compared to the conventional methods for differential diagnosis. A new diagnostic method, the NBI system, was also reviewed in terms of differential diagnosis of colorectal lesions.
Method : 206 lesions in 122 patients were diagnosed with conventional endoscopy, chromoendoscopy and chromoscopy with magnification. The diagnoses at each step were categorized as neoplastic or non-neoplastic according to pit pattern. The accuracy rate for each type of endoscopic diagnosis was evaluated compared with histological diagnoses.
Results : The overall diagnostic accuracies with conventional endoscopy, chromoscopy, chromoscopy with magnification were 84.0 %, 89.3 % and 95.6 %, respectively.
Conclusion : Chromoscopy with magnification is the most reliable method for determining whether a colorectal lesion is non-neoplastic or neoplastic. The accuracy rate in differentiating neoplastic from non-neoplastic lesions was similar with chromoscopy or NBI systems. To establish a new diagnostic algorism, a randomized controlled study should be conducted to estimate the efficacy of NBI colonoscopy systems.
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