表浅型食管癌及上皮内瘤变的胃镜分型与胃镜活检及外科病理差异的相关性分析.pdfVIP

临床与病理杂志 J Cl in Path ol R e s 2016, 36(6) 798 表浅型食管癌及上皮内瘤变的胃镜分型与胃镜活检及外科病理 差异的相关性分析 曹慧，许玉花，王磊，杨成 (南京医科大学附属无锡市人民医院消化科，江苏 无锡 214023) [摘 要] 目的：分析表浅型食管癌及上皮内瘤变的胃镜下分型表现与活检病理及手术病理的差异的相关 性。方法：收集我院2 0 0 8年1月至2 0 1 4年1 2月期间胃镜下诊断为早期食管病变而活检病理为食 管鳞癌或上皮内瘤变的120例手术患者的胃镜标本及手术标本，分析其胃镜下分型与活检病理及 手术病理的差异的关系。结果：活检病理与术后病理间完全符合的占60.0%(72/120)，加重的占 37.5%(45/120)，减轻的占2.5%(3/120)。表浅鳞癌组符合率90.5%，上皮内瘤变组26.3%，二者具 显著差异(P0.05)。而胃镜下1型符合率高(70.0%)，3型最低(42.9%)，具有统计学意义(P0.05)。 而且1、2、3型患者术后病理分析结果显示早期黏膜内及黏膜下浸润(深度及转移)具有明显递增现 象，合并溃疡时均易出现横向纵深浸润进展及淋巴转移。结论：表浅型食管癌术前术后病理存在一 定差异，而胃镜下分型表现与该差异程度有一定关系，并对病变浸润及分化程度有重要提示价值。 [关键词] 表浅型食管癌；上皮内瘤变；胃镜分型；病理；外科手术 Correlation analysis of superficial esophageal cancer and intraepithelial neoplasia under gastroscope classification and differences between gastroscope biopsy and surgical pathology CAO Hui, XU Yuhua, WANG Lei, YANG Cheng (Department of Gastroenterology, Wuxi People’s Hospital of Nanjing Medical University, Wuxi Jiangsu 214023, China) Abstract Objective: To analyze the correlation of classification and performance under gastroscope of superficial esophageal cancer and intraepithelial neoplasia and differences between biopsy pathology and surgical pathology. Methods: Totally 120 specimens of gastroscope and surgery were collected from January 2008 to December 2014, which diagnosed as early esophageal lesions by endoscopy, and confirmed as esophageal squamous cell carcinoma or precancerous lesions by pathology. Then analyzed the correlation of classification and performance under gastroscope and differences between biopsy pathology and surgical pathology. Results: The biopsy pathology which was completely in conformity with postoperative pathology was 60% (72/120), while the exacerbation 收稿日期 (Date of reception)：2016–03–21 通信作者 (Corresponding author)：许玉花，Email: 456441xyh@ doi: 10.3978/j.issn.2095-6959.2016.06.016 View this article at: /10.3978/j.issn.2095-6959.2016.06.016 表浅型食管癌及上皮内瘤变的胃镜分型与胃镜活检及外科病理差异的相关性分析 曹慧，等 799 食管癌作为发病率较高的肿瘤已越来越受到 临床重视，传统手术治疗术后并