Utilidad de la cromoendoscopia magnificada en pólipos colónicos como predictor de cáncer colorrectal según histopatología
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2021
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
El cáncer colorrectal ha aumentado en las últimas dos décadas. En Ecuador no hay registro oficial sobre utilidad de las técnicas endoscópicos actuales, desarrollándose el presente estudio cuya finalidad fue: Determinar la utilidad de la cromoendoscopia magnificada en pólipos colónicos como predictores de cáncer colorrectal según histopatología, planteándose un estudio: Analítico - correlacional, retroprospectivo, no experimental, de corte transversal. Para el análisis de información y su validez, se usó: prueba de correlación Chi cuadrado, con índice de confianza del 99% e índice de error del 1%. Los datos obtenidos demostraron una incidencia del 53.76 % en mayores de 50 años, la proporcionalidad fue de 2.8:1 en varones. De 340 pólipos analizados el tamaño promedio fue de 1.6 mm siendo frecuentes en recto 27.65%, colon ascendente 23.82%, sigmoides 20%, descendente 15.88% y transverso 12.65%. La histología demostró que un 54.41 % fue hiperplásico, el 0.88 % serrado sésil, un 17.94 % adenoma tubular, un 3.24 % adenoma velloso, un 6.76 % túbulo velloso, 6.18 % carcinoma. La clasificación del equipo de expertos NBI de Japón obtuvo la siguiente distribución: JNET 1 con 55 %, JNET 2A con 19.71 %, JNET 2B con 8.24 %, JNET 3 con 17.06 %. La sensibilidad fue del 90.91 % y especificidad del 99.46 %, los valores predictivos positivos fueron = 98.03 % y los valores predictivos negativos = 97.35. Chi cuadrado obtuvo una significación asintótica de 0.001 demostrando relación entre las variables.
Colorectal cancer has increased in the last two decades. In Ecuador there is no official registry on the usefulness of current endoscopic techniques, developing the present study whose purpose was: To determine the usefulness of magnified chromoendoscopy in colonic polyps as predictors of colorectal cancer according to histopathology, considering a study: Analytical - correlational, retroprospective, non-experimental, cross-sectional. For the analysis of information and its validity, the following was used: Chi square correlation test, with a confidence index of 99% and an error rate of 1%. The data obtained showed an incidence of 53.76% in those over 50 years of age, the proportionality was 2.8: 1 in men. Of 340 polyps analyzed, the average size was 1.6 mm, being frequent in the rectum 27.65%, ascending colon 23.82%, sigmoid 20%, descending 15.88% and transverse 12.65%. Histology showed that 54.41% were hyperplastic, 0.88% sessile serrated, 17.94% tubular adenoma, 3.24% villous adenoma, 6.76% tubule villous, 6.18% carcinoma. The classification of the Japan NBI team of experts obtained the following distribution: JNET 1 with 55%, JNET 2A with 19.71%, JNET 2B with 8.24%, JNET 3 with 17.06%. The sensitivity was 90.91% and specificity 99.46%, the positive predictive values were = 98.03% and the negative predictive values = 97.35. Chi square obtained an asymptotic significance of 0.001 showing a relationship between the variables
Colorectal cancer has increased in the last two decades. In Ecuador there is no official registry on the usefulness of current endoscopic techniques, developing the present study whose purpose was: To determine the usefulness of magnified chromoendoscopy in colonic polyps as predictors of colorectal cancer according to histopathology, considering a study: Analytical - correlational, retroprospective, non-experimental, cross-sectional. For the analysis of information and its validity, the following was used: Chi square correlation test, with a confidence index of 99% and an error rate of 1%. The data obtained showed an incidence of 53.76% in those over 50 years of age, the proportionality was 2.8: 1 in men. Of 340 polyps analyzed, the average size was 1.6 mm, being frequent in the rectum 27.65%, ascending colon 23.82%, sigmoid 20%, descending 15.88% and transverse 12.65%. Histology showed that 54.41% were hyperplastic, 0.88% sessile serrated, 17.94% tubular adenoma, 3.24% villous adenoma, 6.76% tubule villous, 6.18% carcinoma. The classification of the Japan NBI team of experts obtained the following distribution: JNET 1 with 55%, JNET 2A with 19.71%, JNET 2B with 8.24%, JNET 3 with 17.06%. The sensitivity was 90.91% and specificity 99.46%, the positive predictive values were = 98.03% and the negative predictive values = 97.35. Chi square obtained an asymptotic significance of 0.001 showing a relationship between the variables
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Neoplasias del Ano, Endoscopia, Estudio de casos, Patología, Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón, Cantón Guayaquil, Ecuador