biophBiomedical PhotonicsBiomedical Photonics2413-9432Non-profit partnership for development of domestic photodynamic therapy and photodiagnosisbioph-6Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSСпектроскопические методы и увеличительная эндоскопия в дифференциальной диагностике патологии толстой кишкиSpectrophotometric methods and magnifying endoscopy for differential diagnosis of colon lesionsРазживинаА. А.RazgivinaА. А.

Кафедра эндоскопии

НечипайА. М.NechipaiА. М.

Кафедра эндоскопии

ВоловаА. В.VolovaА. V.anastssiya-volova@yandex.ruГоряевС. М.GoryaevS. М.

Кафедра эндоскопии

СоколовА. А.SokolovА. А.

Кафедра эндоскопии

Российская медицинская академия непрерывного профессионального образования, Москва, РоссияРоссияThe Department of Endoscopy of Russian Medical Academy of Post-Graduate Education, MoscowRussian Federation201320032013213741Copyright © Разживина А.А., Нечипай А.М., Волова А.В., Горяев С.М., Соколов А.А., 20132013Разживина А.А., Нечипай А.М., Волова А.В., Горяев С.М., Соколов А.А.Razgivina А.А., Nechipai А.М., Volova А.V., Goryaev S.М., Sokolov А.А.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pdt-journal.com/jour/article/view/6

Представлен обзор последних достижений в области диагностики предракового состояния и раннего рака толстой кишки. Приведены результаты применения ряда диагностических методик, дополняющих стандартную колоноскопию. Так, применение систем NBI (узкоспектральная эндоскопия) и FICE позволяет при совместном использовании с системой увеличительной эндоскопии добиться существенного роста чувствительности методов и специфичности диагностики. Однако серьезным недостатком их является окрашивание кишечного содержимого в различные оттенки красного цвета, что затрудняет визуализацию структур и новообразований небольшого размера. При выявлении участков дисплазии различной степени у пациентов с полипами толстой кишки высокую чувствительность и спец- ифичность показали методы увеличительной или zoom-эндоскопии (93,8% и 64,6% соответственно), конфокальной лазерной эндомикроскопии (81% и 82% соответственно), а также оптической когерентной томографии (92% и 84% соответственно). Один из наиболее новых методов – иммунофотодиагностика, показавшая высокую эффективность при выявлении дисплазии и раннего рака у пациентов с полиповидными новообразованиями толстой кишки: чувствительность достигала 78,6%, специфичность – 100%. Несомненный интерес представляют аутофлюоресцентная и флюоресцентная диагностика с использованием экзогенных фотосенсибилизаторов. Исследования показали, что аутофлюоресцентная диагностика является ценным инструментом в дифференциальной диагностике опухолей толстой кишки (чувствительность метода составила 85%, специфичность – 81%).

 

The review of recent development in diagnosis of premalignancy and early cancer in colon is represented. The results of several diagnostic methods which are supplemental for convenient colonoscopy, are described. Thus, NBI system (narrow spectrum endoscopy) and FICE combined with system for magnifying endoscopy significantly improve sensitivity and specifity of diagnostic method. However, the serious disadvantage is coloration of intestinal contents into different shades of red, impeding visualization of small structures and lesions. For detection of dysplasia of different degree in patients with colon polyps high levels of sensitivity and specifity were shown in the methods of magnifying and zoom-endoscopy (93.8% and 64.6%, respectively), confocal laser endomicroscopy (81% and 82%, perspectively), and optic coherent tomography (92% and 84%, respectively). The one of the most recent method – immunophotodiagnosis, showed high efficiency for detection of dysplasia and early cancer in patients with colon polyps: the sensitivity was 78.6%, specifity – 100%. Autofluorescence and fluorescence diagnostics with exogenous photosensitizers. The studies showed that autofluorescence diagnosis was valuable method for differential diagnosis of colon tumors (sensitivity was 85%, specifity – 81%).

 

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The authors declare that there are no conflicts of interest present.