大肠癌相关检查中的肠镜及肠镜活检病理学对于大肠癌诊治的现实应用分析  

Analysis of the practical application of enteroscopy and enteroscopy biopsy pathology in colorectal cancer related tests for the diagnosis and treatment of colorectal cancer

作　　者：李维前 高立永[2] 王恒 纵瑞峰 刘慧 程慧敏 刘霞 LI Weiqian;GAO Liyong;WANG Heng;ZONG Ruifeng;LIU Hui;CHENG Huimin;LIU Xia(Department of Pathology, the Third Affiliated Hospital of Xuzhou Medical University (formerly Xuzhou Medical College), Xuzhou 221003, China;Department of Pathology, Xuzhou First People's Hospital, Xuzhou 221000, China;Endoscopy Center, the Third Affiliated Hospital of Xuzhou Medical University, Xuzhou 221003, China;Department of General Surgery, the Third Affiliated Hospital of Xuzhou Medical University, Xuzhou 221003, China;Department of Pathology, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China)

机构地区：[1]徐州医科大学附属第三医院病理科,江苏徐州221003 [2]江苏省徐州市第一人民医院病理科,江苏徐州221000 [3]徐州医科大学附属第三医院内镜中心,江苏徐州221003 [4]徐州医科大学附属第三医院普外科,江苏徐州221003 [5]徐州医科大学附属医院病理科,江苏徐州221002

出　　处：《中国现代医生》2018年第4期126-129,共4页China Modern Doctor

摘　　要：目的观察研究大肠癌相关检查中的肠镜及肠镜活检病理学的现实临床诊断价值。方法选取2013年10月~2017年10月来院手术根治且术后病理确诊的39例大肠癌患者展开回顾性分析,查看术前进行的相关检查。术前肠镜活检病理和术后标本病理选择性使用连切、特染、免疫组化等实验方法观察病理切片染色结果,甚至通过院外病理会诊或定期复查肠镜再次活检,然后两者对比研究。结果发现手术根治且术后病理确诊大肠癌的39例患者,其中经术前肠镜及肠镜活检病理确诊37例,术前肠镜病理检查和术后病理检查结果无显著性差异(P>0.05)。另外2例由于肠镜不耐受或肿瘤晚期没做肠镜及肠镜活检病理检查,而经影像学检查发现明显肿块后而行手术。结论肠镜及肠镜活检病理诊断可以给大肠癌患者开展术前评估和术前诊断提供有价值的依据,只有少数人无法完成肠镜及肠镜活检病理检查,而其他技术可以弥补结肠镜的不足。且在病理检查中,应采取病理质控措施以求做到早诊断、正确诊断,以免漏诊、误诊。Objective To observe the practically clinical diagnostic value of enteroscopy and enteroscopy biopsy pathology in colorectal cancer related tests.Methods39patients with colorectal cancer who underwent radical surgery and were pathologically confirmed postoperatively from October2013to October2017in our hospital were retrospectively analyzed.The related preoperative examinations were checked.The experimental methods including continuous slice,special staining and immunohistochemistry,etc were selectively used in preoperative enteroscopy biopsy pathology and postoperative specimen pathology to observe the pathological slice staining results,and even pathology consultations outside the hospital or regular review of enteroscopy and re-biopsy were performed.And then the two were compared.Results It was found that in39patients with colorectal cancer who underwent radical surgery and had pathologically confirmed colorectal cancer,there were37cases of colorectal cancer diagnosed by preoperative enteroscopy and enteroscopy biopsy pathology.There was no significant difference between preoperative enteroscopy pathology and postoperative pathological examination(P>0.05).The other2cases did not undergo enteroscopy and enteroscopy biopsy pathological examination because of enteroscopy intolerance or advanced tumor,and underwent surgery after imaging revealing significant tumor.Conclusions The enteroscopy and enteroscopy biopsy pathological diagnosis can provide valuable evidence for preoperative evaluation and preoperative diagnosis of patients with colorectal cancer.Only a few people can not complete enteroscopy and enteroscopy biopsy pathology,while other techniques can make up for the shortage of enteroscopy.And in pathological examination,pathological control measures should be taken in order to achieve early diagnosis,correct diagnosis,so as to avoid misdiagnosis.

关 键 词：术前诊断 大肠癌 病理质控措施 大肠早癌筛查 液体活检 

分 类 号：R735.3[医药卫生—肿瘤]