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目的探讨窄带成像技术(NBI)在儿童Peutz-Jegher综合征(PJS)诊疗中的应用价值。方法回顾性分析15例确诊为PJS以及70例幼年性息肉患儿的临床资料,包括病理类型及息肉表面腺管开口形态,同时比较NBI内镜与传统白光内镜诊断PJS息肉中腺瘤样改变息肉的敏感性与特异性。结果 PJS患儿摘取76枚息肉,其中病理学诊断为腺瘤样改变的息肉12枚,错构瘤息肉64枚。NBI下PJS息肉腺管开口Ⅰ型占69.7%(53/76),Ⅱ或Ⅲ型占27.6%(21/76),PJS患儿Ⅱ、Ⅲ型比例明显高于幼年性息肉。NBI内镜下诊断PJS患儿腺瘤样改变息肉的灵敏度、特异度分别为83.3%(10/12)和98.4%(63/64),高于传统白光内镜的33.3%(4/12)和95.3%(61/64),两种检测方法灵敏度的差异有统计学意义(P<0.05)。结论 NBI内镜有助于判断PJS患儿消化道息肉的病理性质,其判断腺瘤样改变息肉的灵敏度、特异度均高于传统白光内镜。
Objective To investigate the value of narrow-band imaging (NBI) in the diagnosis and treatment of children with Peutz-Jegher’s syndrome (PJS). Methods The clinical data of 15 children diagnosed as PJS and 70 juvenile polyps were retrospectively analyzed. The pathological types and the morphology of the open duct of the polyp were examined retrospectively. At the same time, adenomatous changes of PJS polyps were compared between NBI endoscopy and conventional white light endoscopy Polyps sensitivity and specificity. Results PJS children with 76 polyps removed, including pathological diagnosis of adenomatous polyps changes in 12, 64 cases of hamartoma polyps. In NBI, 69.7% (53/76) were type Ⅰ PJS and 27.6% (21/76) in type Ⅱ or Ⅲ. The proportion of type Ⅱ and type Ⅲ in children with PJS was significantly higher than that in juvenile polyp. NBI endoscopic diagnosis of PJS in children with adenoma-like polyp sensitivity, specificity were 83.3% (10/12) and 98.4% (63/64), higher than the traditional white endoscopy 33.3% (4/12) And 95.3% (61/64), respectively. There was a significant difference in sensitivity between the two methods (P <0.05). Conclusion NBI endoscopic diagnosis of gastrointestinal polyps in children with PJS pathological nature of its diagnosis of adenomatous polyps change the sensitivity and specificity were higher than the traditional white endoscopy.