超声定位下凿洞式深挖活检对Borrmann Ⅳ型胃癌诊断价值的探讨  

The Diagnostic Yield of EUS-guided Holing Biopsy in Borrmann Type Ⅳ Gastric Cancer

作　　者：周辛欣[1] 季峰[1] 陈毅鹏[1] 陈洪潭[1] 单国栋[1] 钟卫祥[1] 

机构地区：[1]浙江大学附属第一医院,浙江杭州310003

出　　处：《中外医学研究》2014年第26期63-64,共2页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨超声内镜定位下凿洞式深挖活检对BorrmannⅣ型胃癌诊断的价值。方法:回顾性分析病理确诊的53例BorrmannⅣ型胃癌的临床资料,比较常规活检及超声内镜定位下凿洞式深挖活检对BorrmannⅣ型胃癌的诊断结果。结果:常规胃镜首次活检诊断BorrmannⅣ型胃癌阳性率30.2%(16/53),活检阴性患者多次重复活检阳性率13.5%(5/37),常规内镜活检总阳性率为39.6%(21/53)。46例BorrmannⅣ型胃癌患者行超声内镜检查,诊断与病理符合率为95.5%(44/46)。21例多次活检阴性患者行超声内镜定位下凿洞式深挖活检,术后标本送病理检查阳性率61.9%(13/21)。仅2例患者活检后创面少量渗血,所有患者术后观察无出血、穿孔等并发症发生。结论:超声内镜定位下凿洞式深挖活检显著提高BorrmannⅣ型胃癌临床内镜活检阳性率,为BorrmannⅣ型胃癌的诊断提供了更有效的病理确诊依据。该操作安全性高,费用少,值得临床推广。Objective：To evaluate the diagnostic yield of EUS-guided holing biopsy in Borrmann type Ⅳ gastric cancer.Method：The clinical diagnose data of 53 cases of Borrmann type Ⅳgastric cancer patients who were confirmed pathologically by operation examination or gastroscopy were analyzed retrospectively.Result：The positive rate of first routine biopsy was 30.2%（16/53）. The cases with negative first routine biopsies were treated with repeated biopsies（2-4 times）,and the positive rate was 13.5%（5/37）.The overall positive rate of gastroscopic routine biopsy was 39.6%（21/53）.46 cases were diagnosised by EUS,and the coincidence rate in diagnosing Borrmann type IV gastric cancer was 95.5%（44/46）.The cases with negative gastroscopic routine biopsy were treated with EUS-guided holing biopsys,and the positive rate was 61.9%（13/21）. Minor bloods oozing in 2 patients were controlled by epinephrine. Neither severe hemorrhage nor perforation was founded in any cases. Conclusion：EUS-guided holing biopsy has superiority of raising the positive rate of gastroscopic biopsy. It is an effective technique to diagnosis Borrmann typeⅣgastric cancer with pathological basis. And the technique is safety and inexpensiveness.

关 键 词：BORRMANN Ⅳ型胃癌 胃镜活检 超声内镜 深挖活检 

分 类 号：R735.2[医药卫生—肿瘤]