50例结肠息肉腺管开口的放大内镜观察分析  

50 cases with colonic polyps endoscopic observation of pit analysis of the amplification

作　　者：刘树清 彭德银 邸雅南 杨林英 

机构地区：[1]北京航天科技集团总医院消化内科,北京100076

出　　处：《河南医学研究》2010年第4期450-452,共3页Henan Medical Research

摘　　要：目的:探讨放大内镜观察腺管开口分型对大肠息肉性病变的诊断价值。方法:肠镜检查中发现息肉性病变后,病灶部位喷洒0.4%靛胭脂,采用放大内镜观察病灶粘膜腺管开口形态,按Kudo分型作病灶性质判断,并与切除或活检组织病理学检查比较。结果:检出大肠息肉性病变50个,非肿瘤性息肉19个,占38%,其中增生性息肉3个(6%),炎症性息肉16个(32%);腺瘤性息肉28个,占56%;进展期大肠癌3例(6%)。非肿瘤性息肉腺管开口均为Ⅰ、Ⅱ型腺管开口;腺瘤型息肉腺管开口为ⅢL、Ⅲs、Ⅳ型分别占22%、12%、12%,3例进展期癌均表现为粘膜腺管开口破坏无结构,为ⅤN型。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结肠癌具有重要意义,V型腺管开口高度提示癌的可能,对指导内镜治疗或手术切除具有重要意义。Objective： Magnifying endoscope observation pit pattern in colorectal polypoid lesions.Methods： Plyps lesions was found by colonoscopy and the lesion site was sprayed 0.4% indigo carmine.Then use magnifying endoscopy mucosal lesions to observe pit morphology.Classification of lesions was determined according to Kudo,and contrasted to the pathological examination of resection or biopsy.Results： The lesions were detected in 50 colorectal polyps,that included 19 non-neoplastic polyps（38%）,3 hyperplastic polyps（6%）,16 inflammatory polyps （32%）,28 adenomatous polyps（56%） and 3 advanced colorectal cancer（6%）.Pit of non-neoplastic polyps wereⅠ,Ⅱtype pit,adenomatous polyps pit for theⅢL（22%）,Ⅲs（12%）,Ⅳ（12%）type,and 3 cases of advanced cancerⅤN type which showed the no structural damage.Conclusion： Pit to determine colorectal tumor non-tumor lesions and early cancer is important.V-pit may be valuable hint to cancer and guide endoscopic therapy or surgery is important.

关 键 词：大肠息肉 腺管开口 粘膜染色 放大内镜 

分 类 号：R574.62[医药卫生—消化系统]