染色内镜联合靶向取材诊断大肠平坦型病变的研究  

The Study of Staining Endoscopy Combining with Sample Targeting in the Diagnosis of Flat Colorectal Lesion

作　　者：袁帅[1] 吴又明[2] 李锐强[1] 宋慧东[3] 

机构地区：[1]南方医科大学附属小榄医院消化科,广东中山528415 [2]南方医科大学附属小榄医院病理科,广东中山528415 [3]广东省广州市红十字会医院消化科,广东广州510515

出　　处：《临床医学工程》2011年第4期520-521,共2页Clinical Medicine & Engineering

基　　金：中山市科技局基金资助项目(2008A130)

摘　　要：目的联合使用色素内镜技术和靶向取材技术,提高大肠平坦型病变的诊断水平。方法常规结肠镜检查发现平坦型病变34例,通过肠镜活检孔于病变部位喷洒靛胭脂染色剂,观察病变范围和腺管开口类型,经粘膜剥离术切除病变组织,所切除病变组织分别行常规随机取材和实体显微镜下靶向取材,对照两者取材方法在病理学诊断上的差异性。结果色素内镜联合靶向取材技术组病理结果:炎症性病变6例,增生性息肉4例,腺瘤性息肉24例(腺瘤性息肉伴低级别上皮内瘤变18例,腺瘤性息肉伴高级别上皮内瘤变6例);对照组炎症性病变12例,增生性息肉4例,腺瘤性息肉18例(腺瘤性息肉伴低级别上皮内廇变17例,腺瘤性息肉伴高级别上皮内廇变1例)。两组在高级别上皮内廇变的检出率上有差异性(P<0.05)。结论大肠平坦型病变具有较高的恶变倾向,色素内镜联合靶向取材技术有助于提高大肠平坦型病变的诊断率,并有望提高大肠早期癌和癌前病变的检出率。Objective To enhance diagnostic level of flat colorectal lesion by combining staining endoscopy with sample targeting technology.Methods 34 cases of flat colorectal lesions were detected through ordinary electron enteroscopy,indigo carmine sodium was sprayed through the biopsy hole on the flat colorectal lesions,the extent of disease and pit pattern were observed,endoscopic mucosal resection was performed on the pathological tissue,and each specimen was examined by targeting biopsy under stereomicroscopy and conventional pathological examination,respectively.Results The pathological diagnosis of experimental group： 6 cases of infectional lesions,4 cases of hyperplastic polyp,24 cases of adenomatous polyp（18 cases of low-grade intraepithelial neoplasia and 6 cases of high-grade intraepithelial neoplasia were included）;while the pathological diagnosis of control group： 12 cases of infectional lesions,4 cases of hyperplastic polyp,18 cases of adenomatous polyp（17 cases of low-grade intraepithelial neoplasia and 1 case of high-grade intraepithelial neoplasia were included）.The detection rate of high-grade intraepithelial neoplasia was significantly different（P 0.05） by comparison between the two groups.Conclusion Flat colorectal lesion is cancerogenic.Staining endoscopy combining with sample targeting technology helps to enhance the diagnostic level of flat colorectal lesion,which is expected to improve the detection rate of early colorectal cancer and precancerous lesions.

关 键 词：染色内镜 靶向取材 大肠平坦型病变 病理学诊断 

分 类 号：R735.34[医药卫生—肿瘤] R446.8[医药卫生—临床医学]