河南食管癌高发区无症状人群食管和贲门粘膜纤维内镜和组织病理诊断比较  

Comparison on endoscopic and histopathological diagnosis on esophagus and gastric cardia in symptom-free subjects from high-incidence area for esophageal cancer in Henan

作　　者：冯常炜[1] 岳文彬[1] 刘宾[2] 张延瑞[3] 高珊珊[1] 范宗民[1] 王道存[1] 常志伟[1] 王宁博[1] 易会兴[1] 王立东[1] 

机构地区：[1]郑州大学医学院癌症研究室 [2]首都医科大学同仁医院消化内科,北京100730 [3]河南省人民医院消化内科,郑州450003

出　　处：《郑州大学学报（医学版）》2002年第6期780-782,共3页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家杰出青年科学基金 3 0 0 2 5 0 16;河南省高校创新人才工程基金;河南省医药卫生创新人才工程基金资助项目

摘　　要：目的 :通过比较食管癌高发区无症状人群食管和贲门粘膜纤维内镜活检和组织病理诊断 ,进一步了解纤维内镜检查在食管和贲门癌前病变筛查中的意义和问题。方法 :利用纤维内镜诊断、粘膜活检组织病理分析 ,对河南食管癌高发区无症状人群 16 34例的资料进行分析。结果 :纤维内镜诊断为正常食管的 5 6 3例中 ,活检组织病理诊断正常占 5 8% ,其余为基底细胞过度增生和间变 ;纤维内镜诊断为慢性食管炎的 193例患者中 ,活检组织病理诊断粘膜上皮各种病变占 38% ,纤维内镜诊断为正常贲门的 779例对象中 ,活检病理诊断正常占 6 5 % ;纤维内镜诊断为慢性贲门炎的 99例患者中 ,粘膜活检病理诊断各种病变占 5 5 %。结论 :食管和贲门轻度病变在纤维内镜下不能识别而造成的随机取样 。Aim: To futher understand the significance and problem in diagnosis of esophageal and gastric cardia precancerous lesions through the comparison of diagnosis on these lesions by endoscopy and histopathology on symptom free subjects from the high incidence area for esophageal cancer.Methods: Diagnosis with endoscopy and histopathology was performed on 1 634 symptom free subjects.Results: Of the 563 subjects diagnosed as normal esophagi by endoscopy, 42% of these subjects showed different lesions as basal cell hyperplasia (BCH) and dysplasia (DYS) by histopathology; of the 779 subjects diagnosed as normal gastric cardia by endoscopy, 35% of these subjects showed different lesions by histopathology.Conclusion: Randomized biopsy sampling procedure due to the unrecognized mild lesions of esophogi and gastric cardia under endoscopy may be the reason for inconsistent diagnosis in endoscopy and histopathology.

关 键 词：河南 食管癌 高发区 无症状人群 食管 贲门 粘膜 纤维内镜 组织病理学 诊断 

分 类 号：R735.1[医药卫生—肿瘤]