文章摘要
叶飞,张开光,张明黎,王业涛,宋继中,虞文永.胃食管上皮内瘤变内镜黏膜下剥离术前后病理结果对比研究[J].中国临床保健杂志,2018,21(2):238-241.
胃食管上皮内瘤变内镜黏膜下剥离术前后病理结果对比研究
The comparative study of pathology between preoperative endoscopic biopsy and endoscopic submucosal dissection (ESD) in patients with gastroesophageal intraepithelial neoplasia
投稿时间:2018-01-05  
DOI:10.3969/J.issn.1672-6790.2018.02.026
中文关键词: 消化系统肿瘤  上皮  内窥镜检查,消化系统  病理过程
英文关键词: Digestive system neoplasms  Epithelium  Endoscopy,digestive system  Pathologic processes
基金项目:安徽省科技攻关课题(1604a0802075)
作者单位E-mail
叶飞 中国科技大学附属第一医院安徽省立医院消化内科,合肥 230001 13865951303@163.com 
张开光 中国科技大学附属第一医院安徽省立医院消化内科,合肥 230001 zhangkaiguang0097@163.com 
张明黎 中国科技大学附属第一医院安徽省立医院消化内科,合肥 230001  
王业涛 中国科技大学附属第一医院安徽省立医院消化内科,合肥 230001  
宋继中 中国科技大学附属第一医院安徽省立医院消化内科,合肥 230001  
虞文永 中国科技大学附属第一医院安徽省立医院消化内科,合肥 230001  
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中文摘要:
      目的 比较胃食管上皮内瘤变患者术前胃镜活检病理与内镜黏膜下剥离术(ESD)后大体标本病理的异同。方法 收集经胃镜活检诊断为胃食管上皮内瘤变并行ESD治疗患者共155例,对比分析术前胃镜病理结果与术后ESD病理结果差异。结果 术前活检病理与术后病理诊断总体完全符合率为52.9%(82/155),其中食管病变和胃病变完全符合率分别为56.8%(46/81)和48.6%(36/74),两者差异无统计学意义(P>0.05)。术前病理为低级别上皮内瘤变(LGIN)和高级别上皮内瘤变(HGIN)的完全完全符合率分别为57.1%(32/56)和50.5%(50/99),差异无统计学意义(P>0.05)。总体术后病理程度较术前加重占40.6%(63/155),食管病变和胃病变分别为39.5%(32/81)和41.9%(31/74)。总体术后病理程度较术前减轻占6.4%(10/155),其中食管病变和胃病变分别为3.7%(3/81)和9.5%(7/74)。在食管病变中术前病理为LGIN者术后病理程度较术前严重占56%(14/25),术前病理为HGIN者术后病理程度较术前严重占32.1%(18/56)。在胃病变中术前病理为LGIN者术后病理程度较术前严重占32.3%(10/31),术前病理为HGIN者术后病理程度较术前严重占48.9%(21/43)。结论 术前病理对诊断有较好的提示价值,但术前活检病理与术后切除病理存在一定差异。对于上皮内瘤变应进行充分评估,积极地ESD治疗同时获得准确的病理诊断。
英文摘要:
      Objective To compare the differences of pathology between preoperative endoscopic biopsy and endoscopic submucosal dissection(ESD) in patients with gastroesophageal intraepithelial neoplasia.Methods A total of 155 patients with gastroesophageal intraepithelial neoplasia treated by ESD were enrolled and the differences of pathologic findings between preoperative endoscopy and postoperative ESD were compared and analyzed.Results The overall coincidence rate of pathological diagnosis was 52.9%(82/155) in preoperative endoscopy and postoperative ESD.The coincidence rates of esophageal lesions and gastric lesions were 56.8%(46/81) and 48.6%(36/74) respectively,and the difference was not statistically significant,while the complete coincidence rates of LGIN and HGIN were 57.1%(32/56) and 50.5%(50/99)respectively,and the difference was not statistically significant either.The overall postoperative pathologic degree was 40.6%(63/155) higher than preoperative endoscopy,with esophageal lesions in 39.5% (32/81) and gastric lesions in 41.9%(31/74) respectively.In esophageal lesions,postoperative pathologic degree was 56%(14/25) higher than preoperative endoscopy with LGIN,while postoperative pathologic degree was 32.1%(18/56) higher than preoperative endoscopy with HGIN.In gastric lesions,postoperative pathologic degree was 32.3%(10/31) higher than preoperative endoscopy with LGIN and 48.9%(21/43) with HGIN.Conclusions Preoperative pathology has a good value for the diagnosis of gastroesophageal intraepithelial neoplasia,but there are some differences between preoperative biopsy and postoperative pathology.Fully evaluation of intraepithelial neoplasia and active ESD treatment could obtain pathological diagnosis accurately.
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