老年人胃巨大溃疡内镜和病理诊断相关性研究  

Correlation between endoscopic and pathologic diagnosis of Giant gastric ulcer in the elderly patients

作　　者：孙国庆[1] 杨莉蓉 张琦[3] 孙昊[4] 

机构地区：[1]江苏职工医科大学,江苏南京210029 [2]南京江宁区东山镇医院内镜中心,江苏南京210000 [3]南京医科大学附属南京第一医院病理科,江苏南京210000 [4]南京医科大学第一附属医院急诊中心,江苏南京210029

出　　处：《实用临床医药杂志》2009年第10期33-35,共3页Journal of Clinical Medicine in Practice

摘　　要：目的探讨老年人巨大溃疡内镜下诊断与病理结果的相关性。方法收集1998～2008年间内镜发现老年人巨大溃疡患者195例。分析内镜表现与病理诊断的相关性。结果巨大溃疡恶性病变在胃窦幽门、胃底贲门、胃角和胃体的发生率分别是43．9％，50．0％，37．7％和44．4％，4组相比没有显著差异（P〉0．05）。内镜诊断巨大溃疡与病理诊断符合率为96．3％，根据受试者操作特征（ROC）曲线，内镜下诊断老年人巨大溃疡的最佳界值为0．518（敏感度0．409，特异性0．626）。结论无论巨大溃疡的位置、大小还是形态等，在良恶性溃疡之间并没有绝对的界限，内镜下诊断老年人巨大溃疡的可信度较低，存在误诊风险，目前内镜下诊断老年人巨大溃疡尚不能替代黏膜组织学检查。Objective To correlate the endoscopic results from giant gastric ulcer with their pathological diagnosis in elderly patients. Methods The correlation analysis was done between gastroscopic manifestations and pathologic diagnosis of 195 patients with giant gastric ulcer in the elderly collected in our hospital from 1998 to 2008. Results The incidence of malignant giant gastric ulcer in the pyloric antrum, cardia fundus, gastric comer and body of gaster were 43.9%, 50.0%, 37.7 % and 44.4%, respectively and there was no significant difference among the four groups（P 〉0.05）. The coincidence rate was 96.3%. According to receiver operating characteristic（ROC） curve, the best cutoff was 0. 518 （sensitivity 0. 409, specificity 0. 626）. Conclusion Between benign and malignant giant gastric ulcer, there is no absolute boundary regardless of location, size or shape. The coincidence rate of the giant gastric ulcer is relatively low and has the risk of misdiagnosis. Making biopsy and pathological examination is necessary in the diagnosis of giant gastric ulcer during routine elderly endoscopic examination.

关 键 词：胃巨大溃疡 内镜 病理 诊断 

分 类 号：R573.1[医药卫生—消化系统]