一种简易内镜下黏膜切除标本病变测量及复原图绘制的新方法  

A new method of lesion measurement and restoration drawing for endoscopic mucosal resection specimen

作　　者：王春宝[1] 王亚健 常红云 崔磊[2] 武卓越 任牡丹[3] 隋燕霞[1] WANG Chunbao;WANG Yajian;CHANG Hongyun;CUI Lei;WU Zhuoyue;REN Mudan;SUI Yanxia(Department of Pathology,the First Affiliated Hospital of Xi'an Jiaotong University,Shanxi Xi'an 710061;School of Information Science and Technology,Northwest University,Shanxi Xi'an 710061,China;Department of Gastroenterology,the First Affiliated Hospital of Xi'an Jiaotong University,Shanxi Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院病理科,陕西西安710061 [2]西北大学信息科学与技术学院,陕西西安710061 [3]西安交通大学第一附属医院消化内科,陕西西安710061

出　　处：《现代肿瘤医学》2020年第23期4057-4060,共4页Journal of Modern Oncology

基　　金：陕西省自然科学基础研究计划一般项目(面上)(编号:2020JM-387)。

摘　　要：目的:探讨一种新的消化道内镜下黏膜切除标本(ESD)病变测量方法的应用价值。方法:选取2018年1月到12月,西安交通大学第一附属医院消化内科ESD切除的消化道黏膜标本45例,经过标准化固定、取材、制片及阅片后,利用写好的ESD专用分析软件进行数据测量、绘制复原图,再与传统方法测量的结果进行对比。结果:采用旧方法和新方法测量病变大小,显示最小病变分别为1.2 mm,1.4 mm,最大病变分别为89.5 mm,100.6 mm,平均大小分别为14.46 mm,14.89 mm。两种方法测量结果差值平均为0.44 mm。利用一致性检验方法统计显示为一般一致性(Kappa系数为0.305)。阴性切缘用旧方法和新方法分别显示切缘距离最短0.2 mm和0.3 mm,最长11.5 mm和20.8 mm,平均距离分别为2.42 mm和2.79 mm,两种方法测量结果的差值平均为0.30 mm。一致性检验方法统计显示为中等一致性(Kappa系数0.541)。新方法和旧方法绘图时间最短分别需5 min,11 min,最长35 min,65 min,平均时间15.18 min,28.20 min。采用新方法较采用传统的计算方法手工画图平均节省时间10.83 min。结论:利用新的ESD测量及画图软件,能够达到和传统手工测量一样的精确度,并且操作更加简便,可以大大节省报告处理的时间,特别适用于对大标本以及复杂病变的测量及画图工作。Objective:To explore the application value of a new method for measuring endoscopic submucosal dissection(ESD)lesions in digestive tract.Methods:Forty-five cases of gastrointestinal mucosa specimens resected by ESD in the Department of Gastroenterology of the First Affiliated Hospital of Xi’an Jiaotong University from January to December in 2018 were selected.After standardized fixation,sampling,preparation and slides reading,we used newly developed special software for ESD to measure lesion size and draw restoration and compared with the results measured by traditional methods.Results:Using the old method and the new method to measure the lesion size,the smallest lesion size was 1.2 mm and 1.4 mm.The largest lesionsize was 89.5 mm and 100.6 mm,and the average size was 14.46 mm and 14.89 mm,respectively.The difference between the results of the two methods was 0.44 mm on average.Statistical analysis using the consistency test method showed general consistency(Kappa coefficient of 0.305).The old method and the new method for negative margins showed that the shortest distance was 0.2 mm and 0.3 mm.The longest was 11.5 mm and 20.8 mm,and the average distance was 2.42 mm and 2.79 mm respectively.The average difference between the two methods was 0.30 mm.The consistency test method statistics showed that it was moderately consistent(Kappa coefficient 0.541).The shortest time of the new method and the old method were 5 min,11 min.The longest time was 35 min,65 min,the average time was 15.18 min,28.20 min.Using the new method saves an average of 10.83 minutes compared to the traditional method of drawing manually.Conclusion:Using the new ESD software,it can achieve the same accuracy as the traditional manual measurement,and the operation is simpler,which can greatly saved the time of report processing,especially suitable for the measurement and drawing of large specimens and complex lesions.

关 键 词：内镜下黏膜切除术 病理诊断 测量 复原图 

分 类 号：R730.4[医药卫生—肿瘤]