The Study Of Predicting The Character Of Colorectal Neoplasms By I-Scan Staining And Chromoendoscopy

Background In recent years the incidence and mortality rates of colorectal cancers are higher than before and show a ascending trend.The mortality of colorectal cancer has a closely correlation to clinical stages.At present,there have no first-level preventing measures for colorectal cancer,so early diagnosis and treatment can significantly improve the prognosis of the patients.Most colorectal cancer come from adenomatous polyp and non-adenomatous polyp commonly can not develop into cancer.So early detection and differential diagnosis of the colorectal neoplasm have important clinical significance.Objective To explore the predictive accuracy of diagnosis in differentiation to colorectal neoplasm with i-Scan staining and chromoendoscopy and the diagnosis value of in colorectal neoplasm with i-Scan staining.Methods 108 patients with colorectal neoplasm were collected from January 2014 to November 2014 in our hospital.Altogether 180 neoplasms were found.All of them were diagnosed and treated by colonoscopy and typical cancers were not included.First,the i-Scan,s model of SE(+4),CE(+2)and TE(c)were applied to enlarge and observe the pit pattern.The pit pattern of picture was taken and classified.Then i-Scan was closed and the lesion was stained with 0.2%indigo carmine under the white light of high-vision colonoscopy.The pit pattern picture was taken and classified too.The pathological type of the lesion was predicted on the basis of the two pit patterns.The predicted pathological type was compared with its pathological type by biopsy and to compare the pathological types with i-Scan staining and chromoendoscopy.Data was compared with x~2 test and standard test p<0.05 was considered statistically significant difference.Results All the 180 neoplasms were diagnosed by pathological biopsy at last.57neoplasms were inflammatory polyps or hyperplastic polyps,about 37.1%.121neoplasms were adenomatous polyp,about 67.2%and 2 neoplasms were cancer or partly cancerization,about 1.1%.The diagnostic sensitivity of i-Scan was 86.2%,the specificity was 78.9%,the accuracy rate was 87.4%,the positive predictive value was 89.8%and the negative predictive value was 72.5%.At the same time,the diagnostic sensitivity of chromoendoscopy was 90.2%,the specificity was 85.9%,the accuracy rate was 90.8%,the positive predictive value was 93.2%and the negative predictive value was 80.3%.The comparison between the two methods in diagnosis of colorectal neoplasm had no significant difference(p>0.05).Conclusion The i-Scan examination can accurate predict the pathological type of colorectal neoplasm.Its accuracy rate was equivalent to the accuracy rate by chromoendoscopy.It has a high application value in diagnosis of colorectal neoplasm.