胃黏膜低级别上皮内瘤变中胃癌检漏的研究  

The research of screening gastric cancer from gastric low grade intraepithelial neoplasia

作　　者：胡月亮[1] 吴云林[1] 李晨[1] 朱燕华[1] 孙萍胡[1] 吴巍[1] 郭滟[2] 蔚青[2] 程时丹[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院消化内科,上海200025 [2]上海交通大学医学院附属瑞金医院病理科,上海200025

出　　处：《胃肠病学和肝病学杂志》2012年第1期13-16,共4页Chinese Journal of Gastroenterology and Hepatology

基　　金：上海市科委医学重大项目(09DZ1950102)

摘　　要：目的探讨胃黏膜低级别上皮内瘤变(low grade intraepithelial neoplasia,LGIEN)中胃癌漏诊的情况。方法胃镜活检病理诊断为LGIEN的190例患者总结内镜下病灶部位和形态分类,并行内镜复查了解胃癌漏诊情况。结果 190例LGIEN患者病灶主要位于胃窦的137例(72.1%)。镜下病灶形态多样,其中糜烂及溃疡98例(51.6%)。190例患者平均随访时间11.7个月,经内镜病理或手术病理证实胃癌14例,HGIEN患者3例,较前加重者占8.95%;其中符合漏诊患者13例(76.5%),符合可能漏诊患者3例(17.6%)。结论胃镜活检病理检查为LGIEN的患者中部分同时存有癌灶,内镜短期、重复检查可减少胃癌漏诊率。Objective To explore the situation of gastric cancer misdiagnosis from gastric low grade intraepithelial neoplasia. Methods 190 cases of low grade intraepithelial neoplasia confirmed by endoscopic biopsy screened were involved.Endoscopic lesion location and shape classification were summarized and these patients should receive endoscopic review to confirm the situation of gastric cancer misdiagnosis. Results The low grade intraepithelial neoplasia lesions were mainly located in sinus ventriculi（72.1%） and its endoscopic appearance were different,erosion and ulceration accounted for 98 cases（51.6%）.The average follow-up time was 11.7 months.The gastric cancer comfired by endoscopic pathology or surgical pathology were 14 cases,HGIEN were 3 cases.Progression to more severe lesions was detected in 8.95%.Among them,13 cases（76.5%） belonged to misdiagnosis and 3 cases（17.6%） may be missed. Conclusion Patients with LGIEN diagnosed by endoscopic biopsy may coexist cancer.Close and standardized follow-up must be given timely in order to reduce missed incidence.

关 键 词：低级别上皮内瘤变 胃癌 漏诊 随访 

分 类 号：R735.2[医药卫生—肿瘤]