如何提高内镜下早期胃癌的诊断水平  

Optimizing early gastric cancer detection under gastroscopy

作　　者：李兆申[1] 邹文斌[1] 

机构地区：[1]第二军医大学附属长海医院消化内科,上海200433

出　　处：《胃肠病学和肝病学杂志》2016年第6期601-604,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：胃癌是我国最常见的消化道肿瘤之一,居恶性肿瘤死亡率的第3位。早期发现胃癌对提高患者生存率、降低死亡率及改善生活质量具有极其重要的意义。但是,目前我国早期胃癌检出率低,仅占胃癌的10%左右。我国的胃镜检查中,胃癌漏诊因种种原因在各级医院时有发生。根据2014年发布的《中国早期胃癌筛查及内镜诊治共识意见》,上消化道胃镜检查应主要针对胃癌高危人群进行机会性筛查或精查,为患者做好充分的胃镜检查前准备,全面细致地观察整个胃腔,正确识别早期胃癌内镜下表现,充分应用染色内镜、放大内镜、超声内镜等新辅助诊断技术,对胃内可疑病灶进行规范化活检并掌握胃癌的病理分型。Gastric cancer is one of the most common digestive tract tumors and the third highest in the mortality of malignant tumors in China. Early detection of gastric cancer is great significant to improve the survival rate, reduce the mortality and improve the life-quality of patients. However, the detection rate of early gastric cancer in China is very low, accounting for only about 10% of all gastric cancers. In our country, the missed diagnosis of gastric cancer has oc- curred frequently in all-level hospitals due to various reasons. According to the Chinese Consensus on the Screening, Endoscopic Diagnosis and Treatment of Early Gastric Cancer in 2014, firstly, gastroseopy should he mainly used as op- portunistic screening or intensive endoscopic examination in the high-risk populations. Secondly, patients should have adequate preparations before gastroscopy examination. Thirdly, endoscopitsts should perform the comprehensive and de- tailed observation of the stomach cavity. Fourthly, we should identify correctly the endoscopic manifestations of early gastric cancer. Fifthly, endoscopitsts are encouraged to take full advantage of assisted diagnostic technologies, like the chromoendoscopy, magnifying endoscopy and endoscopic ultrasound. Sixthly, we should have a standardized biopsy of suspicious lesions in the stomach and be familiar with various pathological types of gastric cancer.

关 键 词：早期胃癌 胃镜 诊断 放大内镜 色素内镜 病理活检 

分 类 号：R735.2[医药卫生—肿瘤]