中外医学研究
中外醫學研究
중외의학연구
CHINESE AND FOREIGN MEDICAL RESEARCH
2014年
26期
63-64
,共2页
周辛欣%季峰%陈毅鹏%陈洪潭%单国栋%钟卫祥
週辛訢%季峰%陳毅鵬%陳洪潭%單國棟%鐘衛祥
주신흔%계봉%진의붕%진홍담%단국동%종위상
BorrmannⅣ型胃癌%胃镜活检%超声内镜%深挖活检
BorrmannⅣ型胃癌%胃鏡活檢%超聲內鏡%深挖活檢
BorrmannⅣ형위암%위경활검%초성내경%심알활검
Borrmann typeⅣgastric cancer%Gastroscopic biopsy%EUS%Holing biopsy
目的：探讨超声内镜定位下凿洞式深挖活检对Borrmann Ⅳ型胃癌诊断的价值。方法：回顾性分析病理确诊的53例Borrmann Ⅳ型胃癌的临床资料，比较常规活检及超声内镜定位下凿洞式深挖活检对Borrmann Ⅳ型胃癌的诊断结果。结果：常规胃镜首次活检诊断Borrmann Ⅳ型胃癌阳性率30.2%(16/53)，活检阴性患者多次重复活检阳性率13.5%(5/37)，常规内镜活检总阳性率为39.6%(21/53)。46例Borrmann Ⅳ型胃癌患者行超声内镜检查，诊断与病理符合率为95.5%(44/46)。21例多次活检阴性患者行超声内镜定位下凿洞式深挖活检，术后标本送病理检查阳性率61.9%(13/21)。仅2例患者活检后创面少量渗血，所有患者术后观察无出血、穿孔等并发症发生。结论：超声内镜定位下凿洞式深挖活检显著提高BorrmannⅣ型胃癌临床内镜活检阳性率，为BorrmannⅣ型胃癌的诊断提供了更有效的病理确诊依据。该操作安全性高，费用少，值得临床推广。
目的：探討超聲內鏡定位下鑿洞式深挖活檢對Borrmann Ⅳ型胃癌診斷的價值。方法：迴顧性分析病理確診的53例Borrmann Ⅳ型胃癌的臨床資料，比較常規活檢及超聲內鏡定位下鑿洞式深挖活檢對Borrmann Ⅳ型胃癌的診斷結果。結果：常規胃鏡首次活檢診斷Borrmann Ⅳ型胃癌暘性率30.2%(16/53)，活檢陰性患者多次重複活檢暘性率13.5%(5/37)，常規內鏡活檢總暘性率為39.6%(21/53)。46例Borrmann Ⅳ型胃癌患者行超聲內鏡檢查，診斷與病理符閤率為95.5%(44/46)。21例多次活檢陰性患者行超聲內鏡定位下鑿洞式深挖活檢，術後標本送病理檢查暘性率61.9%(13/21)。僅2例患者活檢後創麵少量滲血，所有患者術後觀察無齣血、穿孔等併髮癥髮生。結論：超聲內鏡定位下鑿洞式深挖活檢顯著提高BorrmannⅣ型胃癌臨床內鏡活檢暘性率，為BorrmannⅣ型胃癌的診斷提供瞭更有效的病理確診依據。該操作安全性高，費用少，值得臨床推廣。
목적：탐토초성내경정위하착동식심알활검대Borrmann Ⅳ형위암진단적개치。방법：회고성분석병리학진적53례Borrmann Ⅳ형위암적림상자료，비교상규활검급초성내경정위하착동식심알활검대Borrmann Ⅳ형위암적진단결과。결과：상규위경수차활검진단Borrmann Ⅳ형위암양성솔30.2%(16/53)，활검음성환자다차중복활검양성솔13.5%(5/37)，상규내경활검총양성솔위39.6%(21/53)。46례Borrmann Ⅳ형위암환자행초성내경검사，진단여병리부합솔위95.5%(44/46)。21례다차활검음성환자행초성내경정위하착동식심알활검，술후표본송병리검사양성솔61.9%(13/21)。부2례환자활검후창면소량삼혈，소유환자술후관찰무출혈、천공등병발증발생。결론：초성내경정위하착동식심알활검현저제고BorrmannⅣ형위암림상내경활검양성솔，위BorrmannⅣ형위암적진단제공료경유효적병리학진의거。해조작안전성고，비용소，치득림상추엄。
Objective:To evaluate the diagnostic yield of EUS-guided holing biopsy in Borrmann type Ⅳ gastric cancer.Method:The clinical diagnose data of 53 cases of Borrmann type Ⅳgastric cancer patients who were confirmed pathologically by operation examination or gastroscopy were analyzed retrospectively.Result:The positive rate of first routine biopsy was 30.2%(16/53). The cases with negative first routine biopsies were treated with repeated biopsies(2-4 times),and the positive rate was 13.5%(5/37).The overall positive rate of gastroscopic routine biopsy was 39.6%(21/53).46 cases were diagnosised by EUS,and the coincidence rate in diagnosing Borrmann type IV gastric cancer was 95.5%(44/46).The cases with negative gastroscopic routine biopsy were treated with EUS-guided holing biopsys,and the positive rate was 61.9%(13/21). Minor bloods oozing in 2 patients were controlled by epinephrine. Neither severe hemorrhage nor perforation was founded in any cases. Conclusion:EUS-guided holing biopsy has superiority of raising the positive rate of gastroscopic biopsy. It is an effective technique to diagnosis Borrmann typeⅣgastric cancer with pathological basis. And the technique is safety and inexpensiveness.
