Value of blue laser endoscopic linkage color imaging in the diagnosis of benign and malignant lesions in colonic laterally spreading tumor
10.3760/cma.j.cn115355-20230920-00114
- VernacularTitle:蓝激光内镜联动成像对结肠侧向发育型肿瘤病灶良、恶性的诊断价值
- Author:
Jiake XU
1
;
Qing GU
;
Qin LI
Author Information
1. 昆山市第二人民医院消化内科，昆山 215300
- Keywords:
Endoscopy;
Colonic laterally spreading tumor;
Linked color imaging;
Diagnosis
- From:
Cancer Research and Clinic
2024;36(5):347-350
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the application value of blue laser endoscopic linkage color imaging (LCI) in the diagnosis of benign and malignant lesions in colonic laterally spreading tumor (LST).Methods:A retrospective case series study was conducted. The clinical data of 62 patients with colonic LST diagnosed and treated in the Second People's Hospital of Kunshan from June 2019 to June 2022 were retrospectively analyzed. All patients underwent 2 modes of blue laser endoscopic LCI and white light imaging (WLE) combined with indigo blush staining for colonoscopy to determine the benign and malignant LST lesions, and the lesion tissues were taken under the endoscope for pathological diagnosis. Kappa test was used to evaluate the consistency of the diagnostic results of LCI and WLE with pathological diagnosis. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of LCI and WLE for LST. Results:A total of 92 LST lesions were detected in 62 patients. Pathological findings showed that among the 92 lesions, there were 2 inflammatory lesions, 4 proliferative lesions, 46 low-grade intraepithelial neoplasia, 37 high-grade intraepithelial neoplasia and 3 infiltrating cancer in mucosa or under mask. The results of LCI of 92 lesions showed that 4 lesions were type Ⅰ, 39 lesions were type Ⅱ, 45 lesions were type Ⅲ, 2 lesions were inflammatory and 2 lesions were hyperplastic; the diagnosis results of WLE showed that 6 lesions were type Ⅰ, 40 lesions were type Ⅱ, 37 lesions were type Ⅲ, 4 lesions were inflammatory and 5 lesions were proliferative. Among LCI results, 82 neoplastic lesions were consistent with pathological diagnosis, and 4 non-neoplastic lesions were consistent with pathological diagnosis, with a total coincidence rate of 93.48% (86/92); LCI was consistent with pathological diagnosis ( Kappa = 0.586, P < 0.05). Among WLE results, 74 neoplastic lesions were consistent with pathological diagnosis, and 3 non-neoplastic lesions were consistent with pathological diagnosis, with a total coincidence rate of 83.70% (77/92); WLE was consistent with pathological diagnosis ( Kappa =0.447, P < 0.05). The consistency of pathological diagnosis with LCI was higher than that with WLE. ROC analysis showed that the area under the curve of LCI and WLE for the diagnosis of benign and malignant lesions in colonic LST was 0.810 (95% CI: 0.715-0.884) and 0.681 (95% CI: 0.575-0.774), respectively. Conclusions:Blue laser endoscopic LCI has a high consistency with pathological diagnosis in the diagnosis of benign and malignant lesions in colonic LST. It has a high diagnostic value for colonic LST.
