消化道早癌385例临床病理分析  

Early carcinoma of digestive tract: a clinicopathological analysis of 385 cases

作　　者：滕国鑫[1] 杨京彦[1] 王晓映[1] 季昌华[1] 吴洪磊[1] 周成军[1] TENG Guo-xin;YANG Jing-yan;WANG Xiao-ying;JI Chang-hua;WU Hong-lei;ZHOU Cheng-jun(Department of Pathology,the Second Hospital of Shandong University,Jinan 250033,China)

机构地区：[1]山东大学第二医院病理科

出　　处：《临床与实验病理学杂志》2019年第11期1290-1294,共5页Chinese Journal of Clinical and Experimental Pathology

基　　金：山东省重点研发计划项目(2015GSF118101、2018GSF 118146)

摘　　要：目的分析消化道早癌的临床及病理学特征。方法收集2013~2017年接受内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)治疗的消化道早癌患者343例,共385个标本,观察其发生部位、性别分布特征及组织形态学表现,分析ESD标本与活检标本的病理诊断符合率;统计活检标本早癌的检出率及诊断率。结果早癌的诊断率及检出率呈逐年提高趋势;ESD早癌患者男性的检出比例显著高于女性;早癌活检与ESD病理诊断符合率为83.84%,过诊率为8.08%,低诊率为8.08%。结论早癌病理诊断,尤其是活检诊断要注意结构异型性和细胞异型性并重;充分了解消化道早癌的基本临床内镜特点,结合内镜表现初步判断肿瘤分化和浸润深度,参考内镜表现及有经验内镜医师的内镜诊断,有助于提高早癌的病理诊断符合率,活检病理诊断和ESD病理诊断具有较好的一致性。Purpose To analyze the pathologic features and clinical manifestations of early digestive tract cancer.Methods A total of 385 specimens from 343 patients with early digestive tract cancer treated with ESD from 2013 to 2017 were collected,their location,gender distribution and morphological manifestations were observed,and the coincidence rate of pathological diagnosis between ESD and biopsy specimens was analyzed.The detection rate and diagnostic rate of the early cancer were studied in biopsy specimens.Results The diagnostic rate and detection rate of the early cancer were increasing year by year.In patients with early cancer treated with ESD,the detection rate in males was significantly higher than that in females.The coincidence rate of early cancer biopsy and ESD pathological diagnosis was 83.84%.The over-diagnosis rate was 8.08%,and the under-diagnosis rate was 8.08%.Conclusion The pathological diagnosis of early cancer especially by biopsy,should pay equal attention to both structural dysplasia and cellular atypia.Fully understanding the basic clinical endoscopic features of early cancer,preliminarily judging the depth of differentiation and invasion in combination with endoscopic findings and combining endoscopic findings and endoscopic diagnosis of experienced endoscopists are helpful to improve the coincidence rate of pathological diagnosis in early cancer.Biopsy and ESD pathological diagnosis have a good consistency.

关 键 词：早癌 内镜黏膜下剥离术 诊断率 检出率 

分 类 号：R446.8[医药卫生—诊断学]