NGHIÊN CỨU GIÁ TRỊ CỦA NỘI SOI PHÓNG ĐẠI  KẾT HỢP DẢI TẦN ÁNH SÁNG HẸP TRONG DỰ ĐOÁN  MÔ BỆNH HỌC CỦA POLYP ĐẠI TRỰC TRÀNG  KÍCH THƯỚC LỚN TẠI BỆNH VIỆN QUÂN Y 175

Đăng Nguyễn Hải; Xuân Phạm Thị Thanh; Thảo Phạm Thị; Hiều Trần Văn; Vinh Lê Quang; Thúy Phạm Ngọc

doi:10.59354/ydth175.2025.366

Keywords:

Colorectal polyps, Narrow Band Imaging (NBI)

Abstract

Objectives: To evaluate the value of magnifying endoscopy with narrow-band imaging (NBI) in predicting the histopathological outcomes of large colorectal polyps (≥10 mm).

Materials and methods: A cross-sectional study was conducted on 73 patients with 94 large colorectal polyps (≥10 mm) at Military Hospital 175. Polyps were classified according to the JNET classification using magnifying endoscopy with NBI and compared with histopathological results based on the 2019 WHO classification. Diagnostic performance was evaluated in terms of sensitivity, specificity, and accuracy.

Results: According to the JNET classification, the distribution of polyps was as follows: Type 1 (24.5%), Type 2A (63.8%), Type 2B (9.6%), and Type 3 (2.1%). Regarding histopathology, neoplastic polyps accounted for 73.4% (adenomatous polyps: 70.2%; adenocarcinoma: 3.2%), primarily classified as Type 2A (91.7%) and Type 3 (100%). Non-neoplastic polyps constituted 26.6%, predominantly classified as Type 1 (87.0%). The diagnostic performance of the JNET classification for predicting histopathology included: Type 1 (non-neoplastic): Sensitivity: 95.7%, Specificity: 80.0%, Accuracy: 91.5%; Type 2A (low-grade dysplasia): Sensitivity: 86.7%, Specificity: 76.5%, Accuracy: 83.0%; Type 2B (high-grade dysplasia/superficial carcinoma): Sensitivity: 42.9%, Specificity: 93.1%, Accuracy: 89.4%; Type 3 (deeply invasive carcinoma): Sensitivity: 50.0%, Specificity: 98.9%, Accuracy: 97.9%.

Conclusion: Magnifying endoscopy with NBI, based on the JNET classification, demonstrated high accuracy in predicting the histopathology of large colorectal polyps. This technique is especially effective in distinguishing non-neoplastic polyps and deeply invasive carcinomas, contributing to precise classification and management of large polyps.

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