CAJ | 학술논문

[目的]研究结直肠高级别上皮内瘤变的临床及病理特征，探讨外科治疗原则和策略。[方法]45例结直肠肿瘤患者术前经内镜病理活检均诊断为高级别上皮内瘤变者，其中1例行腹腔镜探查，2例扩肛肿瘤局部切除，1例扩肛局部切除后补充行M iles术，2例行姑息性肿瘤手术，余39例行根治性结直肠癌手术，并将手术标本与术前病理作比较。[结果]术后病理活检示45例中有3例仍为高级别上皮内瘤变；42例证实为腺癌，其中1例伴有肝转移，24例有淋巴结转移，17例无淋巴结转移。[结论]术前病理活检确诊的结直肠高级别上皮内瘤变的肿瘤与术后病理活检结果一致性较差，对于这类患者应予积极的外科处理。
[목적]연구결직장고급별상피내류변적림상급병리특정，탐토외과치료원칙화책략。[방법]45례결직장종류환자술전경내경병리활검균진단위고급별상피내류변자，기중1례행복강경탐사，2례확항종류국부절제，1례확항국부절제후보충행M iles술，2례행고식성종류수술，여39례행근치성결직장암수술，병장수술표본여술전병리작비교。[결과]술후병리활검시45례중유3례잉위고급별상피내류변；42예증실위선암，기중1례반유간전이，24례유림파결전이，17례무림파결전이。[결론]술전병리활검학진적결직장고급별상피내류변적종류여술후병리활검결과일치성교차，대우저류환자응여적겁적외과처리。
Objective]To study the clinical and pathological characteristics of high‐grade colorectal in‐traepithelial neoplastic changes and to investigate the principles and strategies in surgical treatment.[Meth‐ods]In the cases with colorectal tumors accepted treatment in the Tongling hospital from January 2010 to January 2014 ,45 cases underwent pre‐operative endoscopicbiopsy and were diagnosed as tumors with high‐grade colorectal intraepithelial neoplastic changes.One underwent laparoscopic exploration ,two had transanal local excisions ,one underwent Miles operation after transanal local excisions ,two had palliative surgery.The remaining 39 cases underwent radical colorectal surgery.The surgical specimens were all ex‐amined pathologically and compared with the pre‐operative diagnosis of the case.[Results]Three cases were pathologically diagnosed as high‐grade intraepithelial neoplasia of the 45 cases.In the 42 cases ,there was one case with liver metastasis ,and 24 cases with lymph node metastasis ,17 cases without lymph node me‐tastasis and one case of simple exploration without lymph node data.[Conclusion]93% patient which pri‐mary diagnosed as high‐grade intraepithelial neoplasia have been confirmed as rectum coloral cancer .Thus the active surgical should be taken in these patients.