胃肠道高级别上皮内瘤变术后病理分析  

Postoperative pathological analysis of high-grade intraepithelial on gastrointestinal tract

作　　者：石向阳[1] 杜四清[1] 

机构地区：[1]皖南医学院附属池州市人民医院消化内科,安徽池州247000

出　　处：《蚌埠医学院学报》2012年第6期674-675,共2页Journal of Bengbu Medical College

摘　　要：目的:探讨胃肠道活组织检查病理诊断高级别上皮内瘤变(high-grade intraepithelial neoplasia,HIN)的价值。方法:对经内镜活检病理诊断为HIN的52例患者的临床和病理资料进行回顾性分析,并与术后病理诊断结果进行对比。结果:内镜下病灶<3 cm的HIN患者27例,其中上消化道18例,术后诊断为癌13例;结直肠9例,术后诊断为癌1例,差异有统计学意义(P=0.004)。内镜下病灶<3 cm与≥3 cm的上消化道肿瘤中诊断为癌者差异无统计学意义(P=1.000);而内镜下病灶<3 cm和≥3 cm的结直肠肿瘤患者中诊断为癌者差异有统计学意义(P=0.002)。结论:术前内镜活检病理为HIN的上消化道病灶,建议积极地治疗。范围<3 cm结直肠病灶,手术治疗则需要十分慎重。Objective：To investigate the pathological diagnostic value of gastrointestinal biopsy on high-grade intraepithelial neoplasia （HIN）. Methods：A retrospective analysis of clinical and pathological information was done in 52 cases who were diagnosed as HIN by endoscopic biopsy ,and the pathological diagnostic results were compared. Results：In total HIN patients ,27 cases were diagnosed as the scope of endoscopic lesion was 〈 3 cm,including 18 cases whose lesion was in upper digestive tract, and 13 cases were diagnosed as cancer with postoperative pathological analysis ;9 cases whose lesion was in colon and rectum, 1 case was diagnosed as cancer. There was statistical difference in the two groups （ P = 0. 004 ）. The ratio of cancer in upper gastrointestinal tract in these two groups whose lesion range was 〈 3 cm or ≥3 cm were compared, there was no difference in two groups which diagnosed cancer in upper gastroinfestfinal tract regardless of lesion ragne（ P = 1. 000） ;but there was statistical difference in colorectal patients whose lesion range was 〈 3 cm or ≥ 3 cm （ P = 0. 002 ）. Conclusions ： It needs to choose an active treatment when preoperative endoscopic biopsy is diagnosed as HIN in upper digestive tract. The surgical operation needs to be prudent when lesion range is 〈 3 cm in colorectal lesion.

关 键 词：胃肿瘤 肠肿瘤 内镜检查 高级别上皮内瘤变 病理学 临床 

分 类 号：R735.2[医药卫生—肿瘤]