中外医学研究
中外醫學研究
중외의학연구
CHINESE AND FOREIGN MEDICAL RESEARCH
2015年
13期
17-18,19
,共3页
结直肠肿瘤%内镜黏膜切除术%窄谱内镜
結直腸腫瘤%內鏡黏膜切除術%窄譜內鏡
결직장종류%내경점막절제술%착보내경
Colorectal neoplasms%Endoscopic mucosal resection%Narrow band imaging
目的：评价窄带色素内镜(NBI)诊治结直肠广基隆起性病变的临床价值。方法：利用NBI观察结直肠广基隆起病灶形态学(腺管开口pit分型及微血管形态)，然后通过内镜黏膜切除术(EMR)切除病灶，与术前对比，评价NBI判断结直肠广基隆起性病变性质的准确性以及内镜微创治疗中的作用。结果：31例病变均予EMR切除，3例Ⅱa+Ⅱc病变予EPMR切除。术后病理提示增生性息肉4个，管状腺瘤或管状绒毛状腺瘤伴低级别上皮内瘤变(LGD)14个(41.2%，14/34)，管状腺瘤或管状绒毛状腺瘤伴高级别上皮内瘤变(HGD)12个(35.3%，12/34)，黏膜内癌2个(5.9%，2/34)，黏膜下癌2个(5.9%，2/34)，其中黏膜下癌转外科手术治疗，但术后病变肠段未发现残留肿瘤组织残留和淋巴结转移；34例病变组织学治愈率为94.1%(32/34)，整块切除率91.2%(31/34)，NBI预判病变性质及浸润深度的准确率为94.1%(32/34)。结论：应用NBI能较准确判断结直肠广基隆起型病灶的性质及浸润深度，从而可进一步指导内镜微创治疗。
目的：評價窄帶色素內鏡(NBI)診治結直腸廣基隆起性病變的臨床價值。方法：利用NBI觀察結直腸廣基隆起病竈形態學(腺管開口pit分型及微血管形態)，然後通過內鏡黏膜切除術(EMR)切除病竈，與術前對比，評價NBI判斷結直腸廣基隆起性病變性質的準確性以及內鏡微創治療中的作用。結果：31例病變均予EMR切除，3例Ⅱa+Ⅱc病變予EPMR切除。術後病理提示增生性息肉4箇，管狀腺瘤或管狀絨毛狀腺瘤伴低級彆上皮內瘤變(LGD)14箇(41.2%，14/34)，管狀腺瘤或管狀絨毛狀腺瘤伴高級彆上皮內瘤變(HGD)12箇(35.3%，12/34)，黏膜內癌2箇(5.9%，2/34)，黏膜下癌2箇(5.9%，2/34)，其中黏膜下癌轉外科手術治療，但術後病變腸段未髮現殘留腫瘤組織殘留和淋巴結轉移；34例病變組織學治愈率為94.1%(32/34)，整塊切除率91.2%(31/34)，NBI預判病變性質及浸潤深度的準確率為94.1%(32/34)。結論：應用NBI能較準確判斷結直腸廣基隆起型病竈的性質及浸潤深度，從而可進一步指導內鏡微創治療。
목적：평개착대색소내경(NBI)진치결직장엄기륭기성병변적림상개치。방법：이용NBI관찰결직장엄기륭기병조형태학(선관개구pit분형급미혈관형태)，연후통과내경점막절제술(EMR)절제병조，여술전대비，평개NBI판단결직장엄기륭기성병변성질적준학성이급내경미창치료중적작용。결과：31례병변균여EMR절제，3례Ⅱa+Ⅱc병변여EPMR절제。술후병리제시증생성식육4개，관상선류혹관상융모상선류반저급별상피내류변(LGD)14개(41.2%，14/34)，관상선류혹관상융모상선류반고급별상피내류변(HGD)12개(35.3%，12/34)，점막내암2개(5.9%，2/34)，점막하암2개(5.9%，2/34)，기중점막하암전외과수술치료，단술후병변장단미발현잔류종류조직잔류화림파결전이；34례병변조직학치유솔위94.1%(32/34)，정괴절제솔91.2%(31/34)，NBI예판병변성질급침윤심도적준학솔위94.1%(32/34)。결론：응용NBI능교준학판단결직장엄기륭기형병조적성질급침윤심도，종이가진일보지도내경미창치료。
Objective:To investigate the clinical effect on narrow band imaging(NBI) for colorectal flat tumors.Method:The association of morphology (Pit Pattern and Capillary Pattern) of colorectal flat lesions resected by EMR with histopathology was observed and the accuracy of estimation of invasive depth by NBI was evaluated.Result:31 cases of lesions were resected by EMR,3 cases of typeⅡa+Ⅱc were received EPMR.Histopathological confirmed that the lesions were Hyperplastic polyp(n=4),tubular adenoma or tubular villous adenoma with low level intraepithelial neoplasia(LGD, n=14,41.2%,14/34),tubular adenoma or tubular villous adenoma with high level intraepithelial neoplasia(LGD,n=12,35.3%,12/34),mucosal carcinoma(n=2,5.9%,2/34),submucosal carcinoma(n=2,5.9%,2/34).Submucosal carcinoma were resected by surgery operation and both the lateral and basal margins of the specimens were free of tumor cells and without surrounding lymph node metastasis.The results of the 34 lesions disposable en-bloc resection rate was 91.2%(31/34),histological curative resection rate was 94.1%(32/34).The accuracy of estimating invasive depth by NBI was 94.1%(32/34).Conclusion:Colorectal lesions of colorectal flat type can accurately be determined by NBI,which can further guide endoscopic minimally invasive treatment.
