哈尔滨医科大学学报
哈爾濱醫科大學學報
합이빈의과대학학보
JOURNAL OF HARBIN MEDICAL UNIVERSITY
2014年
1期
62-65
,共4页
黏膜下切除术%色素内镜%醋酸-靛胭脂染色%病理学诊断
黏膜下切除術%色素內鏡%醋痠-靛胭脂染色%病理學診斷
점막하절제술%색소내경%작산-전연지염색%병이학진단
submucosal resection%chromoendoscopy%acetic acid-indigo carmine dye%patho-logical diagnosis
目的：探讨黏膜下切除术（ ESD ）联合色素内镜在早期胃癌诊断中的临床应用价值。方法195例患者行常规内镜检查，对胃黏膜可疑病灶进行多处活检；然后进行醋酸-靛胭脂染色，比较常规内镜和色素内镜下病灶边界清晰程度，并作出染色后诊断，取活检标本。对疑诊早期胃癌的病变，行ESD后送检病理，观察病变大小、病理诊断和侵犯深度。结果在195例胃黏膜可疑病灶进行活检的病例中，早期胃癌和癌前病变检出为17例，检出率为8.72％（17/195）；胃黏膜异常染色病例中，早期胃癌和癌前病变检出为66例，检出率为33.84％（66/195），明显大于前者（P＜0.05）。胃黏膜异常染色病例中早期胃癌和癌前病变检出包括所有常规内镜检查对早期胃癌和癌前病变检出病例。在66例早期胃癌和癌前病变中，癌前病变49例（74.24％），分化型和未分化型早癌17例（25.76％）。行黏膜下切除术术后，切除组织送检病理，癌前病变38例（57.58％），分化型和未分化型早癌28例（42.42％），行ESD术后送检标本早期胃癌检出率高于活检钳活检检出率（ P＜0.05）。结论 ESD联合色素内镜能够指导内镜下胃黏膜病变的活检，提高早期胃癌和癌前病变的检出率。
目的：探討黏膜下切除術（ ESD ）聯閤色素內鏡在早期胃癌診斷中的臨床應用價值。方法195例患者行常規內鏡檢查，對胃黏膜可疑病竈進行多處活檢；然後進行醋痠-靛胭脂染色，比較常規內鏡和色素內鏡下病竈邊界清晰程度，併作齣染色後診斷，取活檢標本。對疑診早期胃癌的病變，行ESD後送檢病理，觀察病變大小、病理診斷和侵犯深度。結果在195例胃黏膜可疑病竈進行活檢的病例中，早期胃癌和癌前病變檢齣為17例，檢齣率為8.72％（17/195）；胃黏膜異常染色病例中，早期胃癌和癌前病變檢齣為66例，檢齣率為33.84％（66/195），明顯大于前者（P＜0.05）。胃黏膜異常染色病例中早期胃癌和癌前病變檢齣包括所有常規內鏡檢查對早期胃癌和癌前病變檢齣病例。在66例早期胃癌和癌前病變中，癌前病變49例（74.24％），分化型和未分化型早癌17例（25.76％）。行黏膜下切除術術後，切除組織送檢病理，癌前病變38例（57.58％），分化型和未分化型早癌28例（42.42％），行ESD術後送檢標本早期胃癌檢齣率高于活檢鉗活檢檢齣率（ P＜0.05）。結論 ESD聯閤色素內鏡能夠指導內鏡下胃黏膜病變的活檢，提高早期胃癌和癌前病變的檢齣率。
목적：탐토점막하절제술（ ESD ）연합색소내경재조기위암진단중적림상응용개치。방법195례환자행상규내경검사，대위점막가의병조진행다처활검；연후진행작산-전연지염색，비교상규내경화색소내경하병조변계청석정도，병작출염색후진단，취활검표본。대의진조기위암적병변，행ESD후송검병리，관찰병변대소、병리진단화침범심도。결과재195례위점막가의병조진행활검적병례중，조기위암화암전병변검출위17례，검출솔위8.72％（17/195）；위점막이상염색병례중，조기위암화암전병변검출위66례，검출솔위33.84％（66/195），명현대우전자（P＜0.05）。위점막이상염색병례중조기위암화암전병변검출포괄소유상규내경검사대조기위암화암전병변검출병례。재66례조기위암화암전병변중，암전병변49례（74.24％），분화형화미분화형조암17례（25.76％）。행점막하절제술술후，절제조직송검병리，암전병변38례（57.58％），분화형화미분화형조암28례（42.42％），행ESD술후송검표본조기위암검출솔고우활검겸활검검출솔（ P＜0.05）。결론 ESD연합색소내경능구지도내경하위점막병변적활검，제고조기위암화암전병변적검출솔。
Objective To investigate the clinical value of ESD and chromoendoscopy in the de-tection of early gastric cancer and precancerous lesions .Methods One hundred and ninety-five patients underwent endoscopy , with gastric mucosal of suspicious lesions biopsies .After acetic acid joint indigo carmine dyeing , the edge of suspected early gastric cancer and precan-cerous lesions was identified .After endoscopic submucosal dissection ,the form of lesions ,cryp-topenings, and the laterally developmental border were observed .Results In 195 cases of gastric suspicious lesions , 17 cases of early gastric cancer and precancerous lesions were found , and the detection rate was 8.72%(17/195);66 cases of early gastric cancer and precancerous lesions were found by staining , and the detection rate was 33.84%(66/195), greater than the former significantly ( P<0.05 ) .The detection of mucosal abnormalities cases of early gastric cancer and precancerous lesion by staining included all the cases of conventional endoscopy .In 66 cases of early gastric cancer and precancerous lesions , 49 cases were precancerous lesions (74.24%), 17 cases were differentiated and undifferentiated carcinoma (25.76%).In the removal tissue pathology after submucosal resection ( ESD) surgery, 38 cases are precancerous lesions ( 57.58%) , 28 cases were differentiated and undifferentiated type early cancer (42.42%).The early gastric cancer detection rate by ESD was higher than that by biopsy for-ceps biopsy ( P <0.05 ) .Conclusion ESD combined chromoendoscopy can guide biopsy , and improve detection rate of early cancer and precancerous lesion .
