CAJ | 학술논문

目的探讨食管病变上皮乳头内毛细血管袢的形态与病理组织的关系.方法 137例经常规内镜观察食管黏膜有粗糙、糜烂、颜色异常、微隆起等病变及30例食管黏膜正常的志愿者,在窄带成像放大内镜下观察病变部位上皮乳头内毛细血管袢的形态,并在其引导下对病变区行活组织病理检查,将放大内镜下毛细血管袢的形态结果与组织病理诊断对照研究后进行统计学分析.结果 137例食管病变在窄带成像放大内镜引导下对病变区行活组织病理检查确诊鳞癌27例,其中早期食管癌15例;高级别瘤变21例;低级别瘤变23例;食管炎66例.食管癌组85.18%(23/27)为Ⅳ型IPCL、14.82%(4/27)为Ⅲ型IPCL,高级别瘤变组76.19%(16/21)为Ⅲ型IPCL、23.81%(5/21)为Ⅳ型IPCL,低级别瘤变组56.52%(13/23)为Ⅲ型IPCL、43.48%(10/23)为Ⅱ型IPCL,食管炎组90.91%(60/66)为Ⅱ型IPCL、9.09%(6/66)为Ⅰ型IPCL,正常对照组100%IPCL分型为Ⅰ型.食管癌、高级别瘤变的IPCL与食管炎、正常对照组的IPCL比较,差异有统计学意义(P＜0.05).结论根据食管黏膜IPCL的形态类型可以初步判定食管病变的良、恶性,窄带成像放大内镜可应用于食管癌的普查.
목적 탐토식관병변상피유두내모세혈관번적형태여병리조직적관계.방법 137례경상규내경관찰식관점막유조조、미란、안색이상、미륭기등병변급30례식관점막정상적지원자,재착대성상방대내경하관찰병변부위상피유두내모세혈관번적형태,병재기인도하대병변구행활조직병리검사,장방대내경하모세혈관번적형태결과여조직병리진단대조연구후진행통계학분석.결과 137례식관병변재착대성상방대내경인도하대병변구행활조직병리검사학진린암27례,기중조기식관암15례;고급별류변21례;저급별류변23례;식관염66례.식관암조85.18%(23/27)위Ⅳ형IPCL、14.82%(4/27)위Ⅲ형IPCL,고급별류변조76.19%(16/21)위Ⅲ형IPCL、23.81%(5/21)위Ⅳ형IPCL,저급별류변조56.52%(13/23)위Ⅲ형IPCL、43.48%(10/23)위Ⅱ형IPCL,식관염조90.91%(60/66)위Ⅱ형IPCL、9.09%(6/66)위Ⅰ형IPCL,정상대조조100%IPCL분형위Ⅰ형.식관암、고급별류변적IPCL여식관염、정상대조조적IPCL비교,차이유통계학의의(P＜0.05).결론 근거식관점막IPCL적형태류형가이초보판정식관병변적량、악성,착대성상방대내경가응용우식관암적보사.
Objective To study the relationship between the imaging patterns of microvasculature change and histological diagnosis.Methods One hundred and thirty-seven patients with esophageal mucosa roughness,erosion,plaque,abnormal color and indentation in conventional endoscopy and thirty healthy volunteers were enrolled in this study.The magnifying endoscopy images were graded as four patterns by intraepithelial papillary capillary loop(IPCL) changes by NBI .The biopsies underwent pathologic evaluation.The imaging patterns of endoscopy and histological diagnosis were compared and statistically analyzed.Results 137 patients were diagnosed by narrow-band imaging system with magnifying endoscopy combined miniprobe sonography.Among these patients,27 cases were pathologically diagnosed as squamous cancer including 15 cases of early esophageal cancer,21 cases were high grade intraepithelial neoplasia,23 cases were low grade intraepithelial neoplasia,66 cases were chronic inflammation.100% esophageal carcinoma and high grade intraepithelial neoplasia were Ⅳ,Ⅲ type IPCL,56.52% low grade intraepithelial neoplasia was Ⅲ type IPCL,43.48% wasⅡtype IPCL,90.91% esophagitis wasⅡtype IPCL.100% esophageal normal mucosa wasⅠtype IPCL.The difference was significant among esophageal carcinoma,high grade intraepithelial neoplasia and esophagitis,esophageal normal mucosa (P＜0.05).Conclusions The imaging patterns of microvasculature change under NBI magnifying endoscopy were crucial in the diagnosis and identification of benign and malignant of esophageal disease.