超声内镜指引下内镜黏膜切除术大块活检对BorrmannⅣ胃癌的诊断价值  

Diagnostic value of endoscopic ultrasonography-guided endoscopy sucosal resection biopsy in Borrmann type Ⅳ gastric cancer

作　　者：仝巧云[1,2] 周明东[1,2] 袁晋华[1,2] 葛存锦[1,2] 

机构地区：[1]宜昌市中心人民医院消化内科 [2]三峡大学消化疾病研究所,湖北宜昌443003

出　　处：《临床荟萃》2015年第8期888-890,共3页Clinical Focus

摘　　要：目的研究超声内镜指引下内镜黏膜切除术(EMR)大块活检对BorrmannⅣ型胃癌的诊断价值。方法回顾性分析在我院行胃镜检查,并具有完整手术病理资料的弥漫浸润性胃癌69例,其中术前经超声内镜联合EMR大块活检诊断胃癌31例,常规内镜活检诊断38例。比较两组首次活检阳性率、平均活检次数及病理结果。结果超声内镜大块活检组首次活检有26例诊断为胃癌,常规内镜活检组首次活检有23例诊断为胃癌,两组首次活检阳性率为83.8%(26/31)vs 60.5%(23/38)(P<0.05);超声内镜大块活检组平均活检次数1.2次,常规内镜活检组为1.7次。两组病理结果差异无统计学意义。结论超声内镜联合EMR大块活检可提高BorrmannⅣ型胃癌的诊断率。Objective To evaluate the diagnostic value of endoscopic ultrasonography（EUS）guided endoscopy sucosal resection（EMR） biopsy in Borrmann type Ⅳ gastric cancer. Methods The clinical data of 69 cases of Borrmann type Ⅳ gastric cancer with detailed pathologic records were analyzed retrospectively. In the 69 cases, 31 were gastric carcinoma diagnosed by EUS-guided EMR biopsy and 38 were gastric carcinoma diagnosed by routine endoscopic biopsy. The positive rate of the first biopsy, the average time of biopsy and the pathological results were compared between two groups. Results There were 26 patients in EUS-guided EMR biopsy group diagnosed by the first biopsy, while 23 patients in routine biopsy group were diagnosed by the first biopsy. Compared to the routine endoscopic biopsy group, the positive rate of the first biopsy of EUS-guided EMR group was increased （83.8%[26/31] vs 60.5%[-23/38], P 〈0.05）. The average biopsy times was 1.2 in EUS-guided EMR group vs 1.7 in the routine biopsy group. The diagnosis of Borrmann type Ⅳ gastric cancer by EUS guided EMR was in accordance with the pathologic findings of the routine endoscopic biopsy. Conclusion EUS-guided EMR can increase the diagnosis rate of the Borrmann type IV gastric cancer.

关 键 词：胃肿瘤 超声检查 活组织检查 

分 类 号：R735.2[医药卫生—肿瘤]