摘要
背景:慢性胃炎是临床常见的消化系疾病,目前有内镜诊断和病理诊断两种诊断标准,两者的一致性如何,分歧原因何在,值得进一步研究和探讨。目的:了解慢性胃炎内镜诊断与病理诊断的符合率,以缩小两者间的误差,提高确诊率。方法:复习我院2000年内镜诊断为慢性胃炎者的内镜检查和活检病理报告,计算慢性胃炎内镜诊断与病理诊断的符合率。结果:共有11047例次受检查纳入统计分析。在胃窦部,内镜诊断为非萎缩性胃炎而病理诊断为慢性萎缩性胃炎(CAG)者926例次,内镜诊断为CAG而病理诊断为非萎缩性胃炎者1340例次,两者诊断一致者8781例次,总符合率为79.5%(κ=0.550,P<0.001)。在胃体部,内镜诊断为浅表性改变而病理诊断为萎缩性改变者43例次,内镜诊断为萎缩性改变而病理诊断为浅表性改变者143例次,两者诊断一致者383例次,总符合率为67.3%(κ=0.314,P<0.001)。结论:CAG是胃癌癌前状态之一,鉴于其诊断需依赖组织病理学检查,故强调内镜检查时应在胃窦和胃体部作多部位、多处活检,以提高CAG的确诊率。
Background: Chronic gastritis is a common digestive disease in clinics. Two methods, endoscopy and histopathology are used for the diagnosis of chronic gastritis. The consistency and discrepancy of these two diagnostic methods for chronic gastritis are worth further study. Aims: To investigate the consistency rate of endoscopic and pathological diagnosis in chronic gastritis in order to reduce the discrepancy and increase the accuracy of diagnosis. Methods: All materials were reviewed including the endoscopic report and pathological findings of biopsies from patients diagnosed as chronic gastritis endoscopically in Renji Hospital in 2000, and then the consistency rate between these two diagnostic methods was assessed. Results: All 11 047 cases were enrolled, among them 926 cases were diagnosed as non-atrophic gastritis by endoscopy, but proven as chronic atrophic gastritis (CAG) by pathology; 1 340 cases were diagnosed as CAG by endoscopy, but proven as non-atrophic gastritis by pathology in gastric antrum, with a consistency rate of 79.5% (к=0.550, P<0.001). In the gastric corpus, 43 cases were shown to have superficial inflammation by endoscopy, but proven as atrophic lesion by pathology; 143 cases were shown to have atrophic lesion by endoscopy, but proven as superficial inflammation by pathology, and the diagnosis of the two methods were identical in 383 cases with a consistency rate of 67.3% (к=0.314, P<0.001). Conclusions: CAG is a precancerous condition of gastric carcinoma, its diagnosis must be based on histopathology. Therefore, it is necessary to take multiple biopsies at gastric antrum and corpus to improve the accurate diagnosis rate of CAG.
出处
《胃肠病学》
2004年第3期164-166,共3页
Chinese Journal of Gastroenterology
关键词
慢性胃炎
内镜
病理诊断
误差
符合率
Gastritis, Atrophic
Gastritis, Non-atrophic
Endoscopy
Pathology
Consistency
