连续内镜随访对胃黏膜不典型增生患者癌变的早期诊断和治疗作用研究  

Study on the Function of Endoscopy Combined with Follow-up for Early Diagnosis and Treatment of Cancerous Change of Patients with Gastric Epithelial Dysplasia

作　　者：王蕊 

机构地区：[1]开封市陇海医院消化内科,河南开封475000

出　　处：《医学综述》2016年第19期3915-3917,共3页Medical Recapitulate

摘　　要：目的探讨连续内镜随访对胃黏膜不典型增生患者癌变的早期诊断和治疗作用。方法选取2002年5月至2010年1月于开封市陇海医院行胃镜检查并经病理证实为胃黏膜不典型增生并能定期接受胃镜检查的患者126例作为胃镜检查组,选取因重度不典型增生接受内镜下黏膜切除术的患者65例作为治疗组,对两组患者进行连续内镜随访3个月,比较两组患者病变逆转和癌变发生情况。选取同期73例未行定期内镜随访的胃黏膜不典型增生患者作为对照组,比较3个月后胃镜检查组及对照组早期胃癌检出情况。结果胃镜检查组早期胃癌检出率显著高于对照组[9.5%(12/126)比1.4%(1/73),P<0.05]。治疗组检出逆转33例,逆转率50.8%;检出胃癌2例,癌变率3.1%,与胃镜检查组重度不典型增生患者比较,逆转率和癌变率差异均有统计学意义(P<0.05)。结论对胃黏膜不典型增生患者进行连续内镜随访是早期发现胃癌的有效手段,内镜下黏膜切除术是治疗胃黏膜不典型增生的有效方法。Objective To investigate the clinical value of endoscopy combined with follow-up for early diagnosis and treatment of canc erous change of patients with gastric epithelial dysplasia. Methods From May 2002 to Jan. 2010,126 patients diagnosed with gastric epithelial dysplasia by endoscopy and pathology in Kaifeng Longhai Hospital （ endoscopic follow-up group） and 65 patients receiving endoscopic mucosal resection （EMR） （therapy group） due to severe dysplasia were consecutively followed up with endoscopy for 3 months. The percentages of disease reversal and cancerous changes were compared between the two groups. And 73 patients with gastric epithelial dysplasia who did not receive follow-up with endoscopy during the same period were enrolled as a control group. The occurrence of early gastric cancer was compared between the endoscopic follow-up group and control group. Results The percentage of detected cancerous changes of the endoscopic follow-up group was significantly higher than the control group [ 9. 5% （ 12/126 ） vs 1： 4% （1/73）, P 〈 0. 05 ]. In therapy group, the percentage of disease reversal and cancerous changes were 50. 8% （33 cases） and 3.1% （2 cases）, respectively. There was significant difference in the percentage of disease reversal and cancerous changes between the therapy group and the endoscopic follow-up group （ P 〈 0. 05）. Conclusion Consecutive endoscopic follow-up for patients with gastric epithelial dysplasia is an effective tool to detect gastric cancer early. EMR is an effective method to treat gastric epithelial dysplasia.

关 键 词：胃黏膜不典型增生 内镜 随访 内镜下黏膜切除术 

分 类 号：R735.2[医药卫生—肿瘤]