{"id":5612,"date":"2019-04-23T09:00:20","date_gmt":"2019-04-23T09:00:20","guid":{"rendered":"https:\/\/endoscopiaterapeutica.net\/es\/classificacao\/publish-38\/"},"modified":"2021-08-10T01:13:37","modified_gmt":"2021-08-10T01:13:37","slug":"classificacao-endoscopica-de-cromoscopia-com-nbi-narrow-band-image-e-magnificacao-para-tumores-colorretais-proposta-pela-japan-nbi-expert-team-jnet","status":"publish","type":"classificacao","link":"https:\/\/endoscopiaterapeutica.net\/es\/classificacao\/classificacao-endoscopica-de-cromoscopia-com-nbi-narrow-band-image-e-magnificacao-para-tumores-colorretais-proposta-pela-japan-nbi-expert-team-jnet\/","title":{"rendered":"Classifica\u00e7\u00e3o Endosc\u00f3pica de cromoscopia com NBI (Narrow Band Image) e magnifica\u00e7\u00e3o para tumores colorretais proposta pela Japan NBI Expert Team (JNET)"},"content":{"rendered":"

V\u00e1rias classifica\u00e7\u00f5es de NBI com magnifica\u00e7\u00e3o foram propostas para o diagn\u00f3stico de les\u00f5es colorretais no Jap\u00e3o. Entretanto devido \u00e0 multiplicidade de termos para descrever o mesmo achado, a necessidade de incluir o padr\u00e3o de superf\u00edcie e especialmente com objetivo de criar uma classifica\u00e7\u00e3o universal um grupo de 38 especialistas japoneses (JNET) dividiu as les\u00f5es colorretais em 4 subtipos: 1; 2A; 2B e 3\u00a0 baseado nos padr\u00f5es vascular e de superf\u00edcie.<\/p>\n

No tipo 1<\/strong> os vasos s\u00e3o invis\u00edveis ou se vis\u00edveis s\u00e3o semelhantes \u00e0 mucosa adjacente, com pontos regulares escurecidos ou esbranqui\u00e7ados, mas podendo ser tamb\u00e9m com uma superf\u00edcie uniformemente obscurecida.\u00a0 \u00c0 histologia correspondem aos p\u00f3lipos hiperpl\u00e1sicos ou aos adenomas s\u00e9sseis serrilhados.<\/p>\n

\"\"<\/a>

JNET 1<\/p><\/div>\n

 <\/p>\n

No tipo 2A<\/strong> \u2013 distribui\u00e7\u00e3o regular e uniforme dos vasos com um padr\u00e3o reticular bem ordenado. A superf\u00edcie tamb\u00e9m \u00e9 regular podendo ser do padr\u00e3o tubular, dendr\u00edtico ou papilar correspondendo ao padr\u00e3o de Criptas III e IV. E representam os adenomas de baixo grau.<\/p>\n

\"\"<\/a>

JNET 2A<\/p><\/div>\n

 <\/p>\n

Tipo 2B<\/strong> \u2013 os vasos s\u00e3o espessados, dilatados ou serpenginosos, com distribui\u00e7\u00e3o irregular ou desigual, o calibre dos vasos \u00e9 aproximadamente 1,5 vez maior que no tipo 2A. O padr\u00e3o de criptas ainda \u00e9 presente por\u00e9m com irregularidade semelhante ao padr\u00e3o Vi de Kudo.\u00a0\u00a0 Esse subtipo foi proposto para diagnosticar adenomas com displasia de alto\/carcinoma intramucoso ou a carcinomas com invas\u00e3o superficial da submucosa.<\/p>\n

\"\"<\/a>

JNET 2B<\/p><\/div>\n

 <\/p>\n

Entretanto,\u00a0 a sensibilidade e o valor preditivo positivo da tipo 2B foram relativamente inferiores do que dos outros tipos. Por este motivo o tipo 2B foi subdivido em 2B low e 2B high<\/strong>. No 2B \u2013 low, apesar da distribui\u00e7\u00e3o irregular dos vasos, essa distribui\u00e7\u00e3o ainda \u00e9 uniforme, no 2B \u2013 high al\u00e9m da distribui\u00e7\u00e3o irregular ela tamb\u00e9m \u00e9 heterog\u00eanea. O padr\u00e3o de criptas no 2B \u2013 high est\u00e1 irregular e as margens das criptas est\u00e3o destru\u00eddas, enquanto no 2B \u2013 low est\u00e1 apenas irregular, mas com a margem preservada.\u00a0 No tipo 2B \u2013 high mais de 60% das les\u00f5es tem invas\u00e3o profunda da submucosa enquanto que nas les\u00f5es do tipo 2B \u2013 low, a invas\u00e3o profunda da submucosa raramente ocorre.<\/p>\n

\"\"<\/a>

JNET 2B low – high<\/p><\/div>\n

 <\/p>\n

Para as les\u00f5es do subtipo 2B \u2013 high recomenda-se a complementa\u00e7\u00e3o com magnifica\u00e7\u00e3o com cromoscopia convencional (com corante) ou at\u00e9 mesmo com aux\u00edlio da ecoendoscopia. Algoritmo abaixo.<\/p>\n

\"\"<\/a><\/p>\n

Tipo 3<\/strong> \u2013 notam-se \u00e1reas avasculares ou com vasos interrompidos assim como \u00e1reas amorfas com destrui\u00e7\u00e3o do padr\u00e3o de criptas correspondendo ao padr\u00e3o Vn de Kudo. Essas les\u00f5es j\u00e1 apresentam uma invas\u00e3o profunda da submucosa, n\u00e3o estando indicado o tratamento endosc\u00f3pico.<\/p>\n

\"\"<\/a>

JNET3<\/p><\/div>\n

 <\/p>\n

Em conclus\u00e3o, a nova classifica\u00e7\u00e3o JNET fornece crit\u00e9rios para o diagn\u00f3stico histol\u00f3gico \u00f3ptico das les\u00f5es colorretais sendo \u00fateis na pr\u00e1tica di\u00e1ria.<\/p>\n

<\/h5>\n
Leitura recomendada<\/h5>\n
    \n
  • Sano Y, Tanaka S, Kudo SE, et al. NBI magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team (JNET). Dig Endosc 2016;28:526-33.<\/li>\n
  • Sumimoto K, Tanaka S, Shigita K, et al. Clinical impact and characteristics of the NBI magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team (JNET). Gastrointest Endosc 2016;85:816-21.<\/li>\n
  • Sumimoto K, Tanaka S, Shigita K, et al. Diagnostic performance of Japan NBI Expert Team classification for differentiation among on invasive, superficially invasive, and deeply invasive colorectal neoplasia. Gastrointest Endosc 2017;86:700-9.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

    V\u00e1rias classifica\u00e7\u00f5es de NBI com magnifica\u00e7\u00e3o foram propostas para o diagn\u00f3stico de les\u00f5es colorretais…<\/p>\n","protected":false},"featured_media":5613,"template":"","categoria_de_classificacao":[182],"class_list":["post-5612","classificacao","type-classificacao","status-publish","has-post-thumbnail","hentry","categoria_de_classificacao-colon"],"yoast_head":"\nClassifica\u00e7\u00e3o Endosc\u00f3pica de cromoscopia com NBI (Narrow Band Image) e magnifica\u00e7\u00e3o para tumores colorretais proposta pela Japan NBI Expert Team (JNET) • Endoscopia Terapeutica<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/endoscopiaterapeutica.net\/es\/classificacao\/classificacao-endoscopica-de-cromoscopia-com-nbi-narrow-band-image-e-magnificacao-para-tumores-colorretais-proposta-pela-japan-nbi-expert-team-jnet\/\" \/>\n<meta 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