The Clinical Value Of Narrow-Band Imaging(NBI) On The Diagnosis And Treatment Of Early Colorectal Cancers And Precancerous Lesions

Objective To investigate the clinical value of narrow band imaging (NBI) on the diagnosis and treatment of early colorectal cancer and precancerous lesions., and to assess the efficacy of the treatment to early colorectal cancer by means of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection(ESD).Methods Six hundred patients undergoing routine colonoscopy were randomized into three groups:conventional imaging,NBI and chromoendoscopy examination. The rates of lesions in each group were assessed. Early colorectal cancer and precancerous lesions (112 lesions in total)were found in sixty five patients.Pit pattern and blood capillary form of each lesion were examined with ordinary endoscopy,NBI and chromoendoscopy with magnifying endoscope. The image definition of each group were graded. After predicted the pathology types and the depth of invasion of lesions under NBI by observation of pit pattern and vessel.13 patients who have early colorectal cancer were treated by endoscopic mucosal resection (EMR) or endoscopic submucosal dissection(ESD). The removal rate, the incidence of complications and recurrence. Compare histopathology result and the prediction under NBI, and evaluate the significance of NBI in clinical application.Results There are 16 lesions were found by conventional colonoscopy,36 lesions by NBI and 58 by chromoendoscopy. The lesion detecting rate of NBI was higher than that of conventional colonoscopy(P <0.05),but lower than chromoendoscopy(P<0.05).The pit patterns of 112 lesions were observed with NBI according to the Kudo pit pattern. The pit patterns are as follows:1 case of pit patternâ… ,19 of pit patternâ…¡,52 of pit patternâ…¢,23 of pit patternâ…£and 17 of pit patternâ…¤. Compare with histopathology result, pit patternâ… orâ…¡are all hyperplastic polyps; 40 of 52 pit patternâ…¢are canalicular adenoma, the other 12 lesions are tubulovillous adenoma;In pit pattern IV,4 lesions are tubulovillous adenoma,14 lesions are villous adenoma, and 5 are early colorectal cancer. The pit patternâ…¤(pit patternVA 8,pit patternVN 9) are all microinvasive carcinoma. NBI is consistent with the identification and pathological diagnosis for benign and malignant lesion.All the 13 patients were treated by EMR or ESD have complete resect and have no complications, and no recurrence in follow-up examinations.Conclusion Pit pattern and blood capillary form of early colorectal cancer and precancerous lesions could be clearly demonstrated with NBI than with ordinary endoscopy and chromoendoscopy;Observating the pit pattern and vessel of the lesions by NBI we can predict the invasion of early cancer, which could guide for our next treatment;EMR and ESD are safe and effective treatments for early colorectal cancer.