CAJ | 학술논문

目的探讨黏膜切除术后病理在早期食管癌及其癌前病变诊断中的价值.方法对行内镜下黏膜切除的217处早期食管癌及其癌前病变的诊断结果进行回顾性总结,比较活检病理诊断与术后病理诊断的差异,分析黏膜切除术后病理对早期食管癌及其癌前病变的诊断价值及存在的局限性.结果活检病理诊断与术后病理诊断相比,41.9％ (91/217)诊断不足,15.7％(34/217)诊断过度,42.4％(92/217)诊断相符.相对于活检病理,内镜下黏膜切除术后病理还可对病变的分化程度、浸润深度及是否存在脉管瘤栓进行诊断,为下一步的诊断及治疗提供依据.结论内镜下活检病理对于早期食管癌及其癌前病变病理性质的诊断,存在一定的局限性;而内镜下黏膜切除术后病理诊断可以相对客观地评价病理性质,并为是否需要追加进一步治疗提供相对客观的参考依据;临床诊断及治疗方案需要结合两者共同制定.
목적 탐토점막절제술후병리재조기식관암급기암전병변진단중적개치.방법 대행내경하점막절제적217처조기식관암급기암전병변적진단결과진행회고성총결,비교활검병리진단여술후병리진단적차이,분석점막절제술후병리대조기식관암급기암전병변적진단개치급존재적국한성.결과 활검병리진단여술후병리진단상비,41.9％ (91/217)진단불족,15.7％(34/217)진단과도,42.4％(92/217)진단상부.상대우활검병리,내경하점막절제술후병리환가대병변적분화정도、침윤심도급시부존재맥관류전진행진단,위하일보적진단급치료제공의거.결론 내경하활검병리대우조기식관암급기암전병변병이성질적진단,존재일정적국한성;이내경하점막절제술후병리진단가이상대객관지평개병이성질,병위시부수요추가진일보치료제공상대객관적삼고의거;림상진단급치료방안수요결합량자공동제정.
Objective To investigate the differences of histopathological diagnosis between the endoscopic mucosal resection (EMR) specimens and the biopsy specimens,and to evaluate the value and the limitation of EMR in diagnosis of early esophageal cancers and its precursor lesions.Methods A retrospective analysis on 217 lesions with early esophageal cancers or the precursor lesions treated by EMR was performed.The differences between pathological diagnoses of biopsy and EMR were compared.Results Compared with pathologic diagnosis after EMR,the yield of biopsy consisted of 41.9％ (91/217) as under-diagnosed,15.7％ (34/217) as over-diagnosed,and 42.4％ (92/217) as consistent.EMR diagnosis also explicated the differentiation,the grade,the invasive depth and the lympho-vascular infiltration of the lesions.Conclusion The endoscopic biopsy diagnosis is limited for the pathological diagnosis of early esophageal cancer and precancerous lesions,while the EMR sample can provide objective diagnosis and provide the guideline for the further treatment.