CAJ | 학술논문

目的：探讨内镜智能分光比色(FICE)下大肠侧向发育型肿瘤(LST)的诊断及内镜黏膜下剥离术（ESD）对LST的治疗价值。方法回顾性分析2009年1月至2013年1月FICE染色放大内镜诊断LST的腺管开口分型，及ESD治疗LST的疗效，术后腺管开口分型与病理结果对比。结果64例LST患者中，腺管开口Ⅱ型4例、ⅢL型35例、Ⅳ型20例、Ⅴi型5例。病理结果提示4例Ⅱ型患者均为炎性息肉，35例ⅢL型患者中管状腺瘤21例，管状绒毛状腺瘤15例，20例Ⅳ型患者中管状绒毛状腺瘤1例，绒毛状腺瘤16例，早癌3例，5例Ⅴi型患者中绒毛状腺瘤1例，早癌4例。ESD治疗LST的术后安全有效。结论放大内镜诊断LST与病理诊断符合率高， LST恶性程度高，可尽早采用ESD进行治疗。
목적：탐토내경지능분광비색(FICE)하대장측향발육형종류(LST)적진단급내경점막하박리술（ESD）대LST적치료개치。방법회고성분석2009년1월지2013년1월FICE염색방대내경진단LST적선관개구분형，급ESD치료LST적료효，술후선관개구분형여병리결과대비。결과64례LST환자중，선관개구Ⅱ형4례、ⅢL형35례、Ⅳ형20례、Ⅴi형5례。병리결과제시4례Ⅱ형환자균위염성식육，35례ⅢL형환자중관상선류21례，관상융모상선류15례，20례Ⅳ형환자중관상융모상선류1례，융모상선류16례，조암3례，5례Ⅴi형환자중융모상선류1례，조암4례。ESD치료LST적술후안전유효。결론방대내경진단LST여병리진단부합솔고， LST악성정도고，가진조채용ESD진행치료。
Objective To explore the diagnosis of the laterally spreading tumor (LST) in large intestine by Fuji intelligent chromo endoscopy (FICE) and curative value of endoscopic submucosal dissection (ESD) for LST. Methods The pit patterns of LST diagnosed by FICE dyeing magnification endoscopy and curative effect of ESD in the treatment of LST from Jan 2009 to Jan 2013 were retrospectively analyzed. The post-operative pit patterns and the pathologic results were compared. Results Among the 64 patients, there were 4 patients with pitⅡ, 35 patients with pitⅢL, 20 patients with pitⅣ, and 5 with pitⅤi. The pathologic results indicated that 4 patients with pitⅡshowed inflammatory polyps. Twenty-one patients with tubular adenomas and 14 patients with tubulovillous adenomas were found in the 35 patients with pitⅢL. One patient with tubulovillous adenomas, 16 patients with villous adenomas and 3 patients with early cancer were found in the 20 patients with pitⅣ. One patient with tubulovillous adenomas and 4 patients with early cancer were found in the 5 patients with pit Ⅴi. ESD was safe and effective in the treatment of LST. Conclusion The coincidence rate of magnifying FICE in the diagnosis of LST and pathological diagnosis is high. ESD can be used as soon as possible to treat LST when it shows high malignancy level.