The Diagnostic Value And Study Of NICE Classification Under NBI Endoscopy For Colorectal Tumors

Objective:To explore the diagnostic value of NICE typing for colorectal polypoid lesions based on NBI non-magnifying endoscopy,and to evaluate its clinical application value.Methods:In May 2018 to January 2019 at the first hospital of handan city by colonoscopy found 120 patients of colorectal polypoid lesions were retrospectively analyzed,selected lesions in a total of 240 cases,by the same NBI experienced endoscopic physicians to complete the operation,according to the experience of the application of NBI is bounded(5 years)will be divided into four endoscopic physicians average experience group and normal group,and respectively under the white light mode and NBI in real time according to the NICE classification by double blind method independent review polyps images,according to the size of the lesions and select the appropriate treatment,infiltration depth specimens were postoperative pathological changes,The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of colorectal neoplastic and non-neoplastic polyps were evaluated by using NICE type as the gold standard.Results:(1)Lesion sites: 23 in the ileocecal colon,102 in the ascending colon,60 in the transverse colon,15 in the descending colon,31 in the sigmoid colon and 9 in the rectum colon.(2)Lesion size: 144(60%)with a diameter less than or equal to 5mm,including 79 tumor polyps and 65 non-tumor polyps;96(40%)with a diameter greater than 5mm,including 54 tumor polyps and 42 non-tumor polyps.(3)Pathological results:there were 240 lesions in total,including 91 hyperplastic polyps,16 inflammatory polyps,32 tubular adenomas,7 tubular-villous adenomas,3 villous adenomas,2serrated tubular adenomas,7 high-grade intraepithelial neoplasia,16 focal suspicious infiltrations,and 66 unclassified lesions.(4)Comparison of results: the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of NICE typing under NBI endoscopy for colorectal polyps in the experienced group were 89.5%,96.3%,96.7%,88.0% and 92.5%,respectively,the corresponding values of the general group were 85.7%,86.0%,83.2%,89.3% and 85.8%.The difference in accuracy between the two groups was statistically significant(P<0.05).The consistency betweenthe two groups of observers was 0.83,indicating good consistency.The diagnostic accuracy of polyps with diameters ≤ 5mm and > 5mm was 90.3% and 95.8%,respectively,and the difference was statistically significant(P<0.05).Conclusions: NICE typing under NBI endoscopy has good diagnostic value for colorectal tumors,which is suitable for promotion and application in domestic primary hospitals;The accuracy of NICE overall classification under NBI endoscopy in diagnosing the nature of polyp lesions increased with the increase of lesions;The physicians in the experienced group had slightly higher ability to differentiate and diagnose colorectal polypoid lesions by NICE typing under NBI endoscopy than those in the ordinary group.