CAJ | 학술논문

目的探讨早期食管癌的胃镜特征与临床诊断.方法回顾分析24例早期食管癌患者的临床症状、胃镜表现.结果 24例早期食管癌患者胃镜表现:病变直径1.0 cm以内,表面粗糙、混浊,血管纹理模糊4例;黏膜潮红充血,小片状糜烂,周围境界清楚,触之易出血3例;黏膜局灶性不规则斑块状糜烂或浅表溃疡形成5例;黏膜轻度隆起,表面光滑或糜烂,与周围颜色稍异10例(其中息肉样变1例);黏膜局灶性虫蚀样改变,稍有凹陷,白苔覆盖,注水冲洗后病变部潮红或渗血,边界不规则多较清楚2例.病理报告:小细胞癌1例、腺癌l例(贲门部)、高级别上皮内瘤样变9例、低分化腺癌1例、鳞癌12例.结论内镜下早期食管癌主要表现为黏膜色泽的改变,黏膜增厚粗糙以及浅表隆起、浅表凹陷等形态改变.对可疑病灶多点活检(至少4～5块)是提高早期食管癌检出率的关键.
목적 탐토조기식관암적위경특정여림상진단.방법 회고분석24례조기식관암환자적림상증상、위경표현.결과 24례조기식관암환자위경표현:병변직경1.0 cm이내,표면조조、혼탁,혈관문리모호4례;점막조홍충혈,소편상미란,주위경계청초,촉지역출혈3례;점막국조성불규칙반괴상미란혹천표궤양형성5례;점막경도륭기,표면광활혹미란,여주위안색초이10례(기중식육양변1례);점막국조성충식양개변,초유요함,백태복개,주수충세후병변부조홍혹삼혈,변계불규칙다교청초2례.병리보고:소세포암1례、선암l례(분문부)、고급별상피내류양변9례、저분화선암1례、린암12례.결론 내경하조기식관암주요표현위점막색택적개변,점막증후조조이급천표륭기、천표요함등형태개변.대가의병조다점활검(지소4～5괴)시제고조기식관암검출솔적관건.
Objective To research the characteristics of early esophageal cancer's endoscopy and its clini-cal diagnosis. Methods Retrospective analyze the clinical symptoms and endoscopy performance of the 24 cases of early esophageal cancer which were confirmed by opemtion. Results Unaided eye observing of 24 cases of early e-acphageal cancer:diameter of pathological changes within 1.0 cm,there are four cases of the surface rough,turbidity,vascular fuzzy texture, congestive mucosa, small pieces of rotten to the core, around the realm of clear, easy bleeding by touch of three cases. Mucosa focal irregular plaquelike erosion or superficial helcosis of five cases Mucosa mild uplift,smooth surface or erosion, with slightly different colors of 10 cases ( including one case of pelypoid change) Mucosa fo-cal wormhole-like change, a slight hollow, moss-covered, rubeosis or bleeding lesions after water rinse, irregular and clear borders of two cases, pathology report: one case of small cell carcinoma,one case of adenocarcinoma (cardia),High-level intraepithelial neoplasia transformation nine cases, one case of poorly differentiated adenocarcinoma, 12 ca-ses of squamous cell carcinoma. Conculsion Endoscopic early esophageal cancer for the mainfeatures of the mucous membrane color changes, mucosal thickening, transparency and mucosal vascular network st ructure changes, and mu-cosal rough, nodules, plaques, erosion and uplift superficial, shallow depression and other patterns chang, GeneraUe-sions were confined or isolated like chang, irregular, and the mucous membrane around the borderclear. Clinicalofte misdiagnosed, missed diagnosis, early diagnosis to have significant value.