放大内镜及实体镜检查结肠肿瘤性病变(附139例报告)  

Magnifying endoscope and stereomicroscope in diagnosing colon tumor: experience with 139 cases

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作  者:韩宇晶[1] 赖卓胜[1] 王亚东[1] 姜泊[1] 

机构地区:[1]第一军医大学南方医院全军消化内科研究所,广东广州510515

出  处:《第一军医大学学报》2004年第9期1075-1077,共3页Journal of First Military Medical University

基  金:广东省基金项目子课题(2002c30307)~~

摘  要:目的探讨如何通过放大内镜观察到的大肠粘膜腺管开口类型发现早期大肠癌及癌前病变.方法2001年8月~2002年2月结肠镜检查139例大肠病变,采用内镜下粘膜染色技术,结合放大内镜、实体显微镜观察腺管开口分型(pit分型)并与病理诊断对照,pit分型采用工藤分型.结果139例患者中发现大肠息肉124例,进展期癌9例,侧向发育型肿瘤(LST)型病变5例,ⅡC病变1例.LST直径10~50 mm,其中ⅢL型1个,Ⅳ型4个.本组放大内镜与病理、实体镜诊断符合率较高.结论大肠腺管开口对于判断肿瘤性、非肿瘤性病变以及早期大肠癌具有重要意义,如发现有V型腺管开口时则高度提示早期癌的可能.Objective To explore the practical means for identifying early large bowel carcinoma and precancerous lesions with magnifying endoscope. Methods We examined 139 patients with polyp using colonoscopy and mucosal staining, and observed the pit patterns (proposed by Kudo) with magnifying endoscope and stereomicroscope to identify the relations between the pit patterns and the pathologic diagnosis. Results Polyps were identified in 124 patients and advanced cancers in 9. Five laterally spreading tumors (LST) ranging from 10 to 50 mm in diameter, including 1 of pit ⅢL, and 4 of pit Ⅳ. were found. The findings of the pit patterns by magnifying endoscope were highly consistent with those by stereomicroscope in these patients. Conclusions Pit patterns are crucial to distinguish the cancerous lesions form non-cancerous one and helpful for early detection of colorectal cancers. Pit Ⅴ may serve as warning sign of early cancerous lesions.

关 键 词:实体镜 放大内镜 腺管开口 大肠肿瘤性病变 侧向发育型肿瘤 

分 类 号:R735.34[医药卫生—肿瘤]

 

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