| Objective: To compare and analyze the accuracy determination of invasion depth in early colorectal cancer magnifying endoscopy combined with narrow band imaging(ME-NBI)vs endoscopic ultrasonography(EUS),thus to provide a theoretical basis for clinical selection.Methods: The medical records of 86 patients with early colorectal cancer(CRC)who were hospitalized in our hospital from January 2017 to October 2020 and underwent ME-NBI and EUS were retrospectively analyzed.86 patients with early CRC were divided into ME-NBI examination group and EUS examination group per different preoperative examination methods.The accuracy of the two methods was calculated by referring to the medical records and recording the prediction of the depth of invasion of early colorectal cancer together with the depth of invasion reported by postoperative pathology in all patients,furthermore,the agreement between ME-NBI and EUS and the final pathological results was calculated by kappa test,respectively.Results: A total of 86 patients with early colorectal cancer,51 males and 35 females,aged 60.6 ± 7.2,were included in this study.In which there were 55 patients treated with endoscopic submucosal dissection(ESD)and 31 patients with surgery.The results of pathological examination after ESD or surgery showed that there were 64 cases of early colorectal cancer,the depth of invasion was localized in epithelial layer/lamina propria in31 cases,25 cases in mucosal muscular layer,5 cases in superficial submucosa,and 3 cases in deep submucosa;there were 22 cases of advanced cancer with the depth of invasion in lamina propria in 9 cases,and 13 cases in the serosal layer and deeper layer.According to the size of lesions,9 cases had lesions ≤1cm,and 34 cases were 1cm< lesions ≤2cm.39 cases were 2cm < lesion ≤3cm;There were 4 cases with lesions > 3cm.According to the degree of differentiation,54 cases were highly differentiated,24 cases were moderately differentiated and 8 cases were poorly differentiated.According to pathological types,there were 54 cases of adenocarcinoma and 1 case of undifferentiated carcinoma.ME-NBI prediction results: There were 0 cases of JNET type 1 and 2A;67 cases of type 2B,and the depth of invasion was predicted to be the mucosal layer and superficial submucosal layer;and 19 cases of type 3,and the depth of invasion was predicted to be the deep or deeper submucosal layer.ME-NBI was compared with postoperative pathological results,with an accuracy of 83.7%,sensitivity of 93.4%,specificity of 60%,and kappa of 0.575,P < 0.05.The prediction results of EUS: The prediction depth of EUS in epithelial layer/lamina propria in 29 cases;19 cases in mucosal layer,2 cases in superficial submucosa;3 cases in deep submucosa;25 cases in lamina propria;8 cases in serosal layer and deeper layer.The predictive results of EUS were compared with postoperative pathological results: with accuracy of 84.9%,sensitivity of 93.4,specificity of 96%,and kappa of 0.676,P < 0.05.Consistency of ME-NBI and EUS in the accuracy of depth of invasion: Kappa-0.305,P <0.05.Further comparison of the accuracy at all levels revealed that when EUS only predicted the mucosa,its accuracy was 91%,couple with sensitivity of 85.7%,specificity of 100%,and kappa of 0.375,P < 0.05.Conclusion: ME-NBI presented a high accuracy for predicting the depth of invasion of early colorectal cancer and could be used as a means of preoperative evaluation of whether ESD was feasible;EUS also presented a high accuracy for evaluating the depth of invasion of early colorectal cancer with a high accuracy for predicting the accuracy of mucosal invasion,while coupled with poor accuracy for judging the submucosa,and EUS was simpler and more intuitive and could be used as a routine examination. |
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