胃癌术前胃镜活检与外科术后大体标本病理诊断差异分析.docVIP

胃癌术前胃镜活检与外科术后大体标本病理诊断差异分析 　　[摘要] 目的 分析胃癌患者术前胃镜活检病理与外科术后病理诊断结果的差异情况。 方法 选取在我院接受治疗的胃癌患者80例作研究对象，所选患者术前均行胃镜活检病理检查，并在术后行外科病理诊断，对比术前术后两种检查方法的确诊率、病理类型和分化程度。 结果 胃镜活检、术后病理检查的胃癌确诊率、疑似检出率差异有统计学意义（P0.05）。以术后病理诊断结果作为金标准，术前胃镜活检的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为98.4%、33.3%、31.7%、96.9%和50.0%。术前胃镜活检发现管状腺癌7例，乳头状腺癌37例，黏液腺癌36例，术后病理诊断分别发现管状腺癌20例、乳头状腺癌31例、黏液腺癌24例、低粘附性癌5例，两种方法的病理类型差异具有统计学意义；并且胃镜活检和术后病理分化程度相比，差异有统计学意义（P0.05）。 结论 术后胃癌大体标本病理与术前胃镜活检病理诊断结果间存在一定差异，但术前胃镜活检的敏感度、阳性预测值均较高，其在胃癌的早期筛查和预防控制中具有有重要应用价值。 　　[关键词]胃癌；胃镜活检；病理诊断；病理组织类型 　　[中图分类号] R735.2 [文献标识码] B [文章编号] 2095-0616（2015）24-28-04 　　[Abstract] Objective To analyze the difference between preoperative gastroscope biopsy pathology and surgery postoperative pathological diagnosis. Methods 80 cases of gastric cancer patients were selected， and their diagnosis accuracy、pathological pattern and differentiated degree were compared. Results Gastroscope biopsy and postoperative pathologic examination of the gastric cancer diagnosis rate， suspected detection rate have significant difference （P0.05）. The postoperative pathological examination results as the gold standard， the sensitivity of the preoperative gastroscope biopsy， specific degrees， accuracy， positive predictive value， negative predictive value were 98.4%， 33.3%， 31.7%， 33.3% and 50.0%. Preoperative gastroscope biopsy found tubular adenocarcinoma， 7 cases， 37 cases of papillary adenocarcinoma and mucous adenocarcinoma of 36 cases of postoperative pathological diagnosis were found tubular adenocarcinoma 20 cases， 31 cases of papillary adenocarcinoma and mucous adenocarcinoma of 24 cases， low adhesion carcinoma in 5 cases， pathological types of the two methods also have significant differences；And gastroscope biopsy compared with postoperative pathologic differentiation degree， significant difference（P0.05）. Conclusion Specimens of postoperative gastric cancer in general pathology and preoperative gastroscope biopsy pathology diagnosis results， there are some differences between the p