中华消化内镜杂志
中華消化內鏡雜誌
중화소화내경잡지
Chinese Journal of Digestive Endoscopy
2015年
7期
432-434
,共3页
王实%李兆申%崔钊%俞江平%吴伟%陈枭冲
王實%李兆申%崔釗%俞江平%吳偉%陳梟遲
왕실%리조신%최쇠%유강평%오위%진효충
早期食管癌%活组织检查%内镜黏膜下剥离术%病理%上皮内瘤变
早期食管癌%活組織檢查%內鏡黏膜下剝離術%病理%上皮內瘤變
조기식관암%활조직검사%내경점막하박리술%병리%상피내류변
Early esophageal cancer%Biopsy%Endoscopic submucosal dissection%Pathology%Intraepithelial neoplasia
目的 比较食管黏膜病变患者术前胃镜活检病理与内镜黏膜下剥离术(ESD)术后病理的异同.方法 收集浙江省肿瘤医院2013年至2014年胃镜活检诊断为食管黏膜病变并行ESD治疗患者共110例,对比分析术前胃镜病理结果与术后ESD病理结果差异.结果 术前活检病理与术后病理诊断完全符合率为61.8％ (68/110),术后病理程度较术前病理严重占30.0％(33/110),术后病理程度较术前病理轻占8.2％ (9/110).早期食管癌组术前活检与术后病理诊断符合率75.0％(18/24),高于上皮内瘤变组符合率58.1％(50/86),差异有统计学意义(P＜0.05).结论 术前活检病理与术后切除病理存在一定差异,术前病理对诊断有较好的提示价值,但不能完全代表病变性质,对于上皮内瘤变应结合临床经验,积极给予ESD治疗,获得准确诊断的同时对病灶进行处理.
目的 比較食管黏膜病變患者術前胃鏡活檢病理與內鏡黏膜下剝離術(ESD)術後病理的異同.方法 收集浙江省腫瘤醫院2013年至2014年胃鏡活檢診斷為食管黏膜病變併行ESD治療患者共110例,對比分析術前胃鏡病理結果與術後ESD病理結果差異.結果 術前活檢病理與術後病理診斷完全符閤率為61.8％ (68/110),術後病理程度較術前病理嚴重佔30.0％(33/110),術後病理程度較術前病理輕佔8.2％ (9/110).早期食管癌組術前活檢與術後病理診斷符閤率75.0％(18/24),高于上皮內瘤變組符閤率58.1％(50/86),差異有統計學意義(P＜0.05).結論 術前活檢病理與術後切除病理存在一定差異,術前病理對診斷有較好的提示價值,但不能完全代錶病變性質,對于上皮內瘤變應結閤臨床經驗,積極給予ESD治療,穫得準確診斷的同時對病竈進行處理.
목적 비교식관점막병변환자술전위경활검병리여내경점막하박리술(ESD)술후병리적이동.방법 수집절강성종류의원2013년지2014년위경활검진단위식관점막병변병행ESD치료환자공110례,대비분석술전위경병리결과여술후ESD병리결과차이.결과 술전활검병리여술후병리진단완전부합솔위61.8％ (68/110),술후병리정도교술전병리엄중점30.0％(33/110),술후병리정도교술전병리경점8.2％ (9/110).조기식관암조술전활검여술후병리진단부합솔75.0％(18/24),고우상피내류변조부합솔58.1％(50/86),차이유통계학의의(P＜0.05).결론 술전활검병리여술후절제병리존재일정차이,술전병리대진단유교호적제시개치,단불능완전대표병변성질,대우상피내류변응결합림상경험,적겁급여ESD치료,획득준학진단적동시대병조진행처리.
Objective To compare the similarities and differences between the esophageal mucosa lesion pathology before and after endoscopic submucosal dissection (ESD).Methods A total of 110 patients diagnosed as having esophageal mucosal lesions by endoscopic biopsy were treated with ESD at Zhejiang cancer hospital from 2013 to 2014.The results of preoperative and postoperative pathology were compared.Results The consistency rate of preoperative biopsy and postoperative pathologic diagnosis was 61.8％ (68/110).Compared with preoperative pathology,the postoperative pathological results underestimated accounted for 30％ (33/110),the postoperative pathological results overestimated accounted for 8.2％ (9/110).In early esophageal cancer group,consistency rate of preoperative biopsy and postoperative pathologic diagnosis was 75.0％ (18/24),which was higher than that of intraepithelial neoplasia group[58.1％ (50/86)] with significant difference (P ＜ 0.05).Conclusion Preoperative biopsy is not necessarily consistent with postoperative pathology.Though preoperative pathological diagnosis has certain value,it can not completely represent the nature of the lesions.The patients with intraepithelial neoplasia should be actively treated with ESD combined with clinical experiences to get the accurate diagnosis.
