术前活检方法对早期胃癌及上皮内瘤变内镜黏膜下剥离术手术过程的影响  

Effects of preoperative biopsy on endoscopic submucosal dissection （ESD） for early gastric cancer and intraepithelial neoplasia

作　　者：屠惠明[1] 费伯健[2] 杨帆[1] 乔峤[1] 许科斌[1] 李捷[1] 齐晓薇[3] 葛晓松[4] 

机构地区：[1]江南大学附属医院消化内科,江苏省无锡市214062 [2]江南大学附属医院腔镜外科,江苏省无锡市214062 [3]江南大学附属医院病理科,江苏省无锡市214062 [4]江南大学附属医院肿瘤内科,江苏省无锡市214062

出　　处：《中华消化内镜杂志》2015年第11期743-746,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的通过对比分析传统白光成像内镜（C—WLI）多次多点活检术与放大窄带成像内镜（M—NBI）引导内镜下精准靶向活检术，观察并比较这2种活检方法对早期胃癌及上皮内瘤变ESD手术过程的影响。方法按照活检取材方式分为C—WLI多次多块活检组（C组）与M．NBI单次靶向活检组（M组），每组各36例患者。将2组ESD手术的过程进行量化比较。结果M组活检标本数平均（1．45±0．62）块，比C组（9．62±2．25）块明显减少（P〈0．01）。ESD手术过程比较，2组在确定切除范围时间、标记时间以及切除标本处理时间方面差异无统计学意义（P〉0．05），而在黏膜下注射时间、黏膜剥离时间、止血时间以及创面处理时间方面，M组耗时明显短于C组（P〈0．01）。结论NBI引导下的精准靶向活检术，能够明显缩短内镜下ESD手术时间，同时取材数量少，取材阳性率高。Objective To compare the effects of the multi-time patch biopsy under the conventional white light imaging endoscopy （C-WLI） and precise targeted biopsy under magnifying narrow-band imaging endoscopy （M-NBI） on the ESD operation of early gastric cancer and intraepithelial neoplasia. Methods Patients were divided into C-WLI group and M-NBI group, 36 cases in each group. The ESD operations of 2 groups were compared quantitively. Results The mean frequency of selecting biopsy specimen in M-NBI group was （ 1.45 ± 0. 62）, significantly lower than that of C-WLI （ 9.62 ± 2.25 ） （ P 〈 0. 01 ）. There were no significant differences in the time of determining excision extension, marking time and the time of speci- men excision of 2 groups during the ESD operation （P 〉 0. 05 ）. Whereas submucosal injection time, mucosal dissection time, hemostasis time, wound processing time of M-NBI group were significantly shorter than those of C-WLI group （P 〈 0.01 ）. Conclusion Precise targeted biopsy under M-NBI can obviously shorten the time of the endoscopic submucosal dissection （ESD） operation, with small quantity of biopsy tissues and high positive rate of tissues.

关 键 词：活组织检查 癌前病变 早期胃癌 内镜黏膜下剥离术 

分 类 号：R735.2[医药卫生—肿瘤]