| Objective:The purpose of this study was to compare the diagnostic value of blue laser imaging(BLI)combined with traditional micro probe endoscopic ultrasonography(EUS)in predicting the depth of early colorectal tumor invasion.Discuss the influencing factors of inconsistency between endoscopic diagnosis results and pathological examination results.Methods: This clinical study is a single-center,prospective study from the General Hospital of the Western Theater Command of the Chinese People’s Liberation Army.289 patients with early colorectal cancer(CRC)diagnosed by colonoscopy and histopathological examination from January 2018 to December 2020 were included.The patients completed BLI-ME and/or EUS examination and judged the depth of invasion before receiving endoscopic or surgical treatment.Randomly divide the patients into three groups:Group A was treated with blue laser imaging technology,group B was treated with endoscopic ultrasonography,and group C was treated with blue laser imaging technology combined with endoscopic ultrasonography.Results the patients were divided into two groups: mucosa to superficial submucosa(m-sms,infiltration depth < 1000μm)or deep submucosa(SMD,infiltration depth ≥1000μm).The sensitivity,specificity and accuracy of three groups of patients with different endoscopic modes on the depth of invasion of early colorectal cancer were compared and analyzed.The consistency of different endoscopic diagnosis results and pathological results was compared.Univariate analysis of consistent group and non-consistent group,influencing factors of inconsistent results between groups,and the examination time and subjective feelings of patients in group A and group B were compared and analyzed(1-10 points).All cases were single,and multifocal cases were excluded.All patients underwent endoscopic submucosal dissection(ESD)or surgical treatment,and the final diagnosis was postoperative pathology.Results:1.The sensitivity of blue laser imaging combined with magnifying mode,endoscopic ultrasonography and blue laser imaging combined with endoscopic ultrasonography in the diagnosis of deep submucosal invasion of colorectal cancer were 71.8%(28 / 39),73.8%(31 / 42)and 88.8%(32 / 36),and the specificity were 85.5%(59 / 69)and 83.3% respectively The accuracy rates were 80.5%(87 / 108),79.1%(76 / 96)and 88.2%(75 / 85),respectively.The diagnostic accuracy of blue laser imaging combined with EUS was better than that of blue laser imaging group and EUS group.In the blue laser imaging group,EUS group and the blue laser imaging combined with EUS group,80.5%(87 / 108),79.1%(76 / 96)and 88.2%(75 / 85)were consistent with the pathological diagnosis,respectively.2.Compared with the consistency between blue laser imaging and pathological diagnosis(kappa = 0.576)and endoscopic ultrasonography and pathological diagnosis(kappa = 0.574),the consistency between blue laser imaging combined with endoscopic ultrasonography and pathological diagnosis was better(kappa = 0.761).3.According to whether the results of endoscopy are consistent with the results of pathological diagnosis,they are divided into consistent group and non-consistent group,and the inconsistency of the inconsistent factors is analyzed through single factor.The results showed that there were significant differences in age,lesion size,gross shape and depth of invasion(P < 0.05).The time of blue laser imaging was significantly shorter(P < 0.05),and the subjective feeling of patients was significantly better than that of EUS.Conclusion: Blue laser imaging can predict the depth of invasion of colorectal cancer,and the diagnostic effect of this method is similar to that of micro probe endoscopic ultrasonography.Blue laser imaging technology combined with the depth of invasion of early colorectal cancer has high accuracy,accurate and reliable evaluation,and has good clinical application value in preoperative evaluation of early colorectal cancer. |
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