色素放大内镜诊断癌前病变和早期胃癌196例  

Magnification chromoendoscopy for the diagnosis of gastric precancerous lesions and early gastric cancer:an analysis of 196 cases

作　　者：庄丽维[1,2] 王立国[2] 付宜利[1] 

机构地区：[1]哈尔滨工业大学机电学院 [2]哈尔滨医科大学附属第四医院消化内科,黑龙江省哈尔滨市150001

出　　处：《世界华人消化杂志》2010年第20期2141-2145,共5页World Chinese Journal of Digestology

摘　　要：目的:确定胃黏膜萎缩、肠上皮化生(intestinal metaplasia,IM)、异型增生及早期胃癌的放大内镜下形态学特征,探讨色素放大内镜对上述病变诊断的可行性和准确性.方法:应用日本FUJINON EG-590ZW型放大内镜对196例患者进行检查及0.3%靛胭脂染色,观察胃小凹及微血管的改变,总结放大内镜对癌前病变和早期胃癌的诊断分型,与相应部位活检所获得的196个病变组织的病理组织学检查结果进行比较分析.结果:196例患者,经病理证实,浅表性胃炎46例,胃黏膜萎缩76例,萎缩伴IM37例,萎缩伴异型增生36例,早期胃癌1例;放大内镜与病理检查对胃黏膜萎缩、萎缩伴IM、萎缩伴异型增生诊断符合率分别为84.2%,81.1%,72.2%.对癌前病变的总检出率放大内镜为80.5%.结论:放大内镜对癌前病变和早期胃癌有较高的诊断价值.AIM：To evaluate the feasibility and accuracy of magnif ication chromoendoscopy in the diagnosis of gastric atrophy,intestinal metaplasia（IM）,atypical hyperplasia and early gastric cancer. METHODS：One hundred and ninety-six patients were examined by magnif ication chromoendoscopy to observe the changes in gastric pits and microvessels.The classif ication criteria were then developed for the diagnosis of precancerous lesions and early gastric cancer.Histopathological examination of gastric mucosal specimens from these patients was also performed. RESULTS：Of the 196 patients,46 were diagnosed with superficial gastritis,76 with gastric atrophy,37 with atrophy and IM,36 with atrophy and dysplasia,and 1 with early gastric cancer.The diagnostic coincidence rates between magnification chromoendoscopy and pathological examination for gastric atrophy,atrophy with IM,and atrophy with dysplasia were 84.2%,81.1% and 72.2%,respectively.The total detection rate of precancerous lesions by magnif ication chromoendoscopy was 80.5%. CONCLUSION：Magnification chromoendoscopy has a high diagnostic value for gastric precancerous lesions and early gastric cancer.

关 键 词：色素放大内镜 小凹形态 微血管 癌前病变 早期胃癌 

分 类 号：R735.2[医药卫生—肿瘤]