胃上皮内瘤变内镜活检与内镜粘膜下剥离术后的病理诊断差异分析及影响因素研究  

Difference analysis of pathological diagnosis and influencing factors of gastric intraepithelial neoplasia after endoscopic biopsy and endoscopic submucosal dissection

作　　者：杨俊 Yang Jun(Endoscopy Center,Anyang Cancer Hospital,Anyang 455000,Henan,China)

机构地区：[1]安阳市肿瘤医院内镜中心,河南安阳455000

出　　处：《航空航天医学杂志》2025年第1期4-6,共3页Journal of Aerospace medicine

摘　　要：目的分析胃上皮内瘤变内镜活检(Gastric Intraepithelial Neoplasia,GIN)与内镜粘膜下剥离术(Endoscopic Submucosal Dissection,ESD)的病理诊断差异分析及影响因素。方法选取2022年12月至2024年03月期间在本院接受治疗的86例胃黏膜上皮内瘤变患者作为研究对象。分别对患者进行活检与术后病理诊断,并分析诊断结果一致性。将患者根据诊断结果分为病理一致组和病理升级组。对影响胃上皮内瘤变内镜活检与内镜粘膜下剥离术后病理诊断差异的单因素和多因素进行分析。结果在86例患者中,69例病理诊断前后一致,17例术后病理诊断升级。单因素分析表明,取材数目、表面充血、表面溃疡是升级的危险因素(P<0.05)。多因素分析确认这些因素为病理升级的独立危险因素。结论内镜活检与ESD术后病理存在差异,术前活检提示低级别上皮内瘤变且存在特定风险因素时,需警惕病理低估的可能性。Objective To analyze the difference in pathologic diagnosis between endoscopic biopsy of gastric intraepithelial neoplasia(GIN)and endoscopic submucosal dissection(ESD)and the factors affecting it.Methods 86 patients with gastric mucosal intraepithelial neoplasia who were treated in our hospital from December 2022 to March 2024 were selected as the study objects.Biopsy and postoperative pathological diagnosis were performed respectively,and the consistency of diagnosis results was analyzed.According to the diagnosis results,the patients were divided into pathological consistency group and pathological upgrade group.The single and multiple factors affecting the difference of pathological diagnosis of gastric intraepithelial neoplasia after endoscopic biopsy and endoscopic submucosal dissection were analyzed.Results Of the 86 patients,69 were consistent in pathological diagnosis and 17 were upgraded after operation.Univariate analysis showed that the number of samples,surface congestion and surface ulcer were the risk factors for upgrading(P<0.05).Multivariate analysis identified these factors as independent risk factors for pathological escalation.Conclusions Endoscopic biopsy and ESD postoperative pathology are not the same things.There may be a pathological underestimate when a preoperative biopsy reveals Low-grade Intraepithelial Neoplasia(LGIN)and specific risk factors.

关 键 词：胃黏膜上皮内瘤变 内镜下粘膜剥离术 病理活检 诊断差异 影响因素 

分 类 号：R735.2[医药卫生—肿瘤]