放大肠镜与染色技术在诊治早期结肠肿瘤中的应用  

Application of magnifying endoscope binding staining technique in diagnose and therapy the Early colon tumor

作　　者：王恒[1] 

机构地区：[1]徐州医学院附属第三医院消化内科,江苏徐州221003

出　　处：《医学检验与临床》2008年第5期66-68,共3页Medical Laboratory Science and Clinics

摘　　要：目的研究大肠息肉大小、表面结构形态和病理组织学关系,提高对大肠癌早期病变的检出率及实时诊治水平。方法对60例85枚大肠息肉用0.4%靛胭脂染色,放大内镜观察其腺管开口形态,在根据工藤法基础上增加了混合型,Ⅰ、Ⅱ型为非瘤性息肉,ⅢL、ⅢS、Ⅳ及混合型为腺瘤性息肉,ⅤI、ⅤN型为癌变,比较息肉腺管开口形态与息肉形态、大小和病理之间的关系。结果带蒂息肉多为Ⅰ、Ⅱ型(11/14),ⅢL、ⅢS、Ⅳ、ⅤI、ⅤN及混合型主要为亚蒂和广基息肉(49/71),ⅤI、ⅤN型均伴有糜烂、溃疡和质地脆;小于1.0cm息肉多见于Ⅰ、Ⅱ型(28/37),Ⅲ、Ⅳ、Ⅴ及混合型多大于1.0cm(45/52);炎性、增生及幼年性息肉中非瘤性形态分型85.7%,瘤性形态分型14.3%;腺瘤中非瘤性形态分型6.1%,瘤性形态分型93.9%。分型判断瘤性和非瘤性息肉的敏感性为92.2%和85.3%,特异性为87.9%和90.4%,其诊断准确性为90.2%。结论放大内镜结合黏膜染色分析大肠息肉腺管开口形态,能有效鉴别大肠非瘤性息肉、腺瘤和癌,在检查过程中实时地有效地选择性处理大肠息肉。Objective To investigate the relationship between the size、the morphous surface structure and the pathohistology of polyp of colon l in intestinum crassum, and elevate the detection rate and the level of diagnose and therapy at real timefor the morning process carcinoma of large intestine. Methods Basing on the Kudo, 85 pieces of polyp of colon from 60 patients were divided into six types: Ⅰ、Ⅱare no-tumor polyp of colon, ⅢL、ⅢS、Ⅳand mixed type are adenomatous polyp, ⅤI、ⅤN are tumor. Using 0.4% indigo carmine staining and observe the shape debouch of cryptae with magnifying endoscope, then compare the relation between the shape debouch of cryptae and the shape、size、pathohistology of polypus. Results The pedicle skin flap polypi are Ⅰ、Ⅱtype(11/14), the sub-pedicel polypi and wide base polypi are ⅢL、ⅢS、Ⅳ、ⅤI、ⅤN and mixed type (49/71), furthermore ⅤI、ⅤN type accompany with the anabrosis and crisp texture; the polypi which diameter <1.0cm are Ⅰ、Ⅱtype(28/37), those diameter >1.0cm are Ⅲ、Ⅳ、Ⅴand mixed type (43/52); the no-tumor type is 85.7% and the tumor type is 14.3% in those polypi which phlegmasia, accrementitionand juvenile polyp; the no-tumor type is 6.1% and the tumor type is 93.9% in those adenoid tumor. For type judging tumor and no-tumor, the sensibility is 92.2% and 85.3%, and the specificity is 87.9% and 90.4%, the accuracy is 90.2%. Conclusion The technique for magnifying endoscope binding mucosa staining which analyze the cryptae shape of polyp of colon inintestinum crassum, can discriminate the no-tumor, adenoid tumor and tumor effectively, and treat the polyp intestinal in intestinum crassum during the detect effectively and in time.

关 键 词：放大肠镜 靛胭脂 结肠息肉 病理分型 

分 类 号：R735.34[医药卫生—肿瘤]