我们研究了 AA 增强窄带成像 (NBI) 放大内窥镜 (ANBI-ME) 诊断浅表结直肠肿瘤的理想乙酸 (AA) 浓度，并评估了其临床疗效。在探索阶段，我们研究了四个通过对 50 个浅表结直肠肿瘤在每个浓度下进行 ANBI-ME，轮流使用不同浓度（1.5%、2.25%、3.0% 和 4.5%）。通过评估诊断准确性、AA 美白持续时间 (AD)、蠕动和内镜切除后出血来确定有利的 AA 浓度。在验证阶段，我们评估了 ANBI-ME 观察者间与确定的 AA 浓度的一致性以及方法间一致性，随后对探索组和 98 名其他患者进行了结晶紫染色放大内窥镜检查 (CV-ME)。 1.5% AA 的诊断准确率为 89.3% (42/47)，2.25% 的诊断准确率为 92.0% (46/50)，3.0% 的诊断准确率为 96.8% (61/63)，4.5% 的诊断准确率为 97.8% (46/47)。无显着差异（p = 0.26）。 AA 浓度和 AD 之间存在显着的正相关性 (p < 0.001)。没有观察到蠕动亢进或切除后出血的显着差异。确定最佳AA浓度为4.5%。在验证分析中，使用 AMBI-ME 的准确率为 72.4% (105/145)，使用 CV-ME 的准确率为 68.3% (99/145) (p = 0.43)。两个观察者之间（ANBI-ME 的 κ，0.87；CV-ME 的 0.83）和方法之间（每位观察者的 κ，0.87 和 0.81）之间存在很强的一致性。为了诊断结直肠病变，ANBI 中的 AA 浓度为 4.5% -ME 安全有效。其诊断性能与 CV-ME 相当，未来的大样本研究可能证实其作为可靠的替代内窥镜诊断方法的潜力。版权所有 © 2024 美国胃肠内窥镜协会。由爱思唯尔公司出版。保留所有权利。

We investigated the ideal acetic acid (AA) concentration for AA-enhanced, narrow-band imaging (NBI) magnifying endoscopy (ANBI-ME) in the diagnosis of superficial colorectal neoplasms and evaluated its clinical efficacy.During the exploratory phase, we investigated four concentrations (1.5%, 2.25%, 3.0%, and 4.5%) in rotation by performing ANBI-ME on 50 superficial colorectal neoplasms at each concentration. A favorable AA concentration was determined by evaluating the diagnostic accuracy, AA whitening duration (AD), peristalsis, and bleeding following endoscopic resection. In the validation phase, we assessed inter-observer agreements for ANBI-ME with the determined AA concentration and inter-methodological agreements between that and subsequently conducted crystal violet-stained magnifying endoscopy (CV-ME) with the exploratory set and 98 additional patients.The diagnostic accuracies were 89.3% (42/47) for 1.5% AA, 92.0% (46/50) for 2.25%, 96.8% (61/63) for 3.0%, and 97.8% (46/47) for 4.5% with no significant difference (p = 0.26). A significant positive correlation was observed between the AA concentrations and ADs (p < 0.001). No significant differences in hyperperistalsis or post-resection bleeding were observed. The optimal AA concentration was determined to be 4.5%. In the validation analysis, the accuracy rates were 72.4% (105/145) using AMBI-ME and 68.3% (99/145) using CV-ME (p = 0.43). Strong agreements were noted between two observers (κ, 0.87 for ANBI-ME; 0.83 for CV-ME) and between the methods (κ, 0.87 and 0.81 for each observer).For diagnosing colorectal lesions, an AA concentration of 4.5% in ANBI-ME was safe and effective. Its diagnostic performance was comparable to CV-ME, and future large-sample studies may confirm its potential as a reliable alternative endoscopic diagnostic method.Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.