窄带成像结合放大内镜和超声内镜评估在早期结直肠癌内镜下治疗前的价值

doi:10.20223/j.cnki.1000-8535.2025.07.015

摘要/Abstract

摘要： 目的分析早期结直肠癌内镜下治疗前行窄带成像结合放大内镜（ME-NBI）和超声内镜技术的评估价值。方法采用回顾性分析方法,以2021年1月— 2023 年 12月中山市第五人民医院收治的102例早期结直肠癌患者为观察对象,所有患者均接受内镜下黏膜切除术（EMR）或内镜黏膜下剥离术（ESD）治疗,根据内镜下治疗前是否进行ME-NBI和超声内镜检查分为研究组与对照组各51例。比较两组年龄、性别、肿瘤大小、直乙结肠占比及组织病理特征;比较两组治疗时间、ESD治疗后非治愈性切除发生率、治愈性切除率、并发症发生情况及再次ESD或外科手术治疗率。结果两组年龄、性别、肿瘤大小、直乙结肠占比及组织病理比较差异均无统计学意义（P>0.05）。研究组中37例行ESD治疗,治疗时间为（120.6±140.3）min,12例行EMR治疗,治疗时间为（11.6±9.3）min,有2例不符合内镜下治疗指征,转外科手术治疗。对照组有38例行ESD治疗,治疗时间为（128.8±144.5）min,13例行EMR治疗,治疗时间为（12.5±9.5）min,两者治疗时间比较差异均无统计学意义（P>0.05）。研究组非治愈性切除率为7.84,低于对照组27.45;治愈性切除率为88.24,高于对照组72.55;研究组ESD手术并发症为8.11%,低于对照组31.58;ESD或外科手术率为6.12,低于对照组25.49（P<0.05）,结论 ME-NBI和超声内镜对早期结直肠癌患者行内镜下治疗指征评估更准确,可提高治愈性切除率。

关键词: 早期结直肠癌, 窄带成像结合放大内镜, 超声内镜, 内镜黏膜下剥离术

Abstract: Objective To study the application value of magnifying endoscopy combined with narrow band imaging （ME-NBI）and ultrasonic endoscopy system before endoscopic treatment in patients with early colorectal cancer．Methods A retrospective analysis was carried out on 102 patients with early-stage colorectal cancer who were admitted to Zhongshan Fifth People's Hospital from January 2021 to December 2023．All patients were treated with endoscopic mucosal resection（EMR）or endoscopic submucosal dissection（ESD）．The patients were divided into study group（51 cases）and control group（51 cases）according to whether ME-NBI and ultrasonic endoscopy was performed before endoscopic treatment or not．The patient age,sex,volume of tumor,location of tumor and pathological result of the tumor were compared between two groups．Time for treatment,curative resection rate,non-curative resection rate and the complication incidence of ESD,incidences of second ESD or surgery were compared between the two groups．Results There were no statistical differences in age,sex,volume of tumor,location of tumor and pathological result of the tumor（P>0.05）．In the study group,37 patients received ESD treatment,operation time was（120.6±140.3）minutes,and 12 patients received EMR treatment,operation time was（11.6±9.3）minutes,two cases were transferred to surgery due to endoscopic ultrasonography combined with magnifying endoscopy showed that they did not meet the indications for ESD treatment．In the control group,38 patients received ESD treatment,operation time was（128.8±144.5）minutes,13 patients received EMR treatment,operation time was（12.5±9.5）minutes．There was no significant difference in treatment duration between the two groups．The non-curative resection rate of the study group was 7.84%,which was significantly lower than that in the control group（27.45%）,and the curative resection rate（88.24%）was significantly higher than that in the control group（72.55%）．The complications of ESD surgery in the study group were 8.11%,lower than 31.58% in the control group． The rate of second ESD or surgery was 6.12%,lower than 25.49% in the control group（P<0.05）．Conclusions ME-NBI and endoscopic ultrasound are more accurate in the evaluation of endoscopic indications for early colorectal cancer patients,and can improve the curative resection rate．

Key words: early colorectal cancer, magnifying endoscopy combined with narrow band imaging, ultrasonic endoscopy, endoscopic submucosal dissection

戴小华, 石胜利, 袁帅, 李锐强. 窄带成像结合放大内镜和超声内镜评估在早期结直肠癌内镜下治疗前的价值[J]. 广州医药, 2025, 56(7): 957-962.

DAI Xiaohua, SHI Shengli, YUAN Shuai, LI Ruiqiang. Application value of magnifying endoscopy combined with narrow band imaging and ultrasonic endoscopy system before endoscopic treatment in patients with early colorectal cancer[J]. Guangzhou Medical Journal, 2025, 56(7): 957-962.

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