摘要
目的应用放大内镜联合黏膜染色技术来寻找表面型病变(Ⅱ型),比较大肠黏膜隆起型病变(Ⅰ型)和Ⅱ型病变的癌变率。方法连续3000例患者通过放大结肠镜检查来寻找大肠隆起型与表面型病变。应用息肉切除术或内镜黏膜切除术切除病变,全标本进行病理学研究。结果在3000例患者中,643例患者发现大肠黏膜病变(Ⅰ型、Ⅱ型)725处,其中Ⅱ型病变占病变总数的7.179%(61/725)。725处病变中有659个腺瘤。659个腺瘤中Ⅰ型病变598个(90.74%),Ⅱ型病变61个(9.26%)。全标本进行病理学检查发现Ⅰ型和Ⅱ型腺瘤性病变发生轻-中度异型增生,重度异型增生和早期癌的例数分别为269/598(44.98%)和34/61(55.73%)、43/598(7.19%)和11/61(18.03%)、7/598(1.17%)和6/61(9.84%)。结论重度异型增生和早期癌的发现率Ⅱ型明显高于Ⅰ型病变。大肠黏膜腺瘤Ⅱ型病变与Ⅰ型病变比较,具有更高的癌变率。
[Objective] Combining magnifying endoscope with mucosa staining technique to identify fiat lesions （typeⅡ）. Comparing the different carcinomatous change rates between colorectal protruded （typeⅠ） lesions and flat lesions （typeⅡ）. [Methods] 3000 consecutive patients underwent magnifying endoscopy to detect colorectal type Ⅰ lesions and type II lesions. Indentified lesions were treated with polypectomy and endoscopic mucosal resection （EMR） technique. The histopathology of all lesions was confirmed by evaluation of endoscopic resection specimens.[Results] 725 lesions （typeⅠ,Ⅱ） were detected in 643 patients out of 3000 undergone magnifying endoscopy. 61 （7.179%） of 725 were type Ⅱ lesions. 659 of the 725 lesions were adenomas： 598 （90.74%） were type Ⅰ lesions, 61 （9.26%） were type Ⅱ lesions. Mild-moderate, severe dysplasia and early eoloreetal cancer were observed in 269/598 （44.98%） and 34/61 （55.73%）, 43/598 （7.19%） and 11/61 （18.03%）, 7/598 （1.17%） and 6/61 （9.84%） of type Ⅰ andtype Ⅱ adenomatous lesions, respectively. [Conclusions] The detection rates of severe dysplasia and early colorectal cancer in type Ⅱ lesions are higher than that of type Ⅰ lesions, type Ⅱ adenomatous lesions are more likely to be carcinomatous compared with type Ⅰ adenomatous lesions.
出处
《中国内镜杂志》
CSCD
北大核心
2005年第7期711-713,共3页
China Journal of Endoscopy
关键词
放大内镜
黏膜染色
表面型病变
大肠肿瘤
magnifying endoscope
mucosa staining
flat lesion
colorectal neoplasm
