摘要
目的探讨染色放大内镜下观察大肠黏膜腺管开口分型对诊治大肠息肉性病变的临床价值。方法在行常规肠镜检查发现的73例息肉样病变中,给予0.2%的靛胭脂染色,结合放大技术观察息肉表面黏膜腺管开口形态,在工藤分型法基础上增加了混合型,Ⅰ、Ⅱ型为非瘤性息肉,ⅢS、ⅢL、Ⅳ及混合型为腺瘤性息肉,V型为癌变,比较息肉腺管开口形态与组织病理之间的关系。结果在检出的73枚大肠息肉病变中,病理诊断非肿瘤性息肉共22枚,内镜下非肿瘤性腺管形态(Ⅰ～Ⅱ型)占86.4%(19/22),肿瘤性腺管形态(ⅢL及混合型)占13.6%(3/22);病理诊断肿瘤性息肉共39枚,内镜下非肿瘤性腺管形态(Ⅰ型)占2.6%(1/39),肿瘤性腺管形态(ⅢL、ⅢS、Ⅳ、混合型)占97.4%(38/39);病理诊断腺癌12枚,都无一例外的呈Ⅴ开口。诊断非肿瘤性(Ⅰ～Ⅱ型)和肿瘤性(Ⅲ～Ⅴ型)息肉病变的病理符合率达94.5%(69/73);诊断非肿瘤性息肉诊敏感性达86.4%,特异性达95.0%;诊断肿瘤性息肉的敏感性达98.0%,特异性达94.3%。结论大肠腺管开口对判断大肠息肉病变性质有较高的病理符合率,并能有效的鉴别肿瘤性、非肿瘤性病变,有助于在检查过程中及时的选择处理大肠息肉。
Objective To investigate the clinical value of staining magnifying colonoscopy in observation of colorectal polyps lesions mucosal pit.Methods 73 cases with polypoid lesions found with conventional colonoscopy were stained with 0.2% indigo carmine and combined with amplification technique to observe the polyp surface mucosal pit form.Based on Kudo＇s classification method,mixed type was added.The standard was the below： Type I,II were non-neoplastic polyps,type II,IIIS,IIIL,Ⅳ,and mixed type were adenomatous polyps and type V were cancerous.The relationship between morphology of polyp pit and histopathology was analyzed.Results In 73 lesions with colorectal polyps,pathologically non-neoplastic polyps were 22 medals,endoscopic non-neoplastic gonadal duct morphology（Ⅰ-Ⅱ） accounted for 86.4%（19/22）,cancerous gonadal duct morphology（Ⅲ L and mixed type） accounted for 13.6%（3/22）;pathologically neoplastic polyps were 39 medals,endoscopic non-neoplastic gonadal duct morphology（type I） accounted for 2.6%（1/39）,neoplastic gonadal duct morphology（Ⅲ L,Ⅲ S,Ⅳ,mixed） accounted for 97.4%（38/39）;pathological adenocarcinoma were 12 medals,all showed a V opening.Compared to pathology,the coincidence rate of this method was 94.5%（69/73） and its specificity and sensitivity were 86.4%,95% respectively in diagnosis of non-cancerous polyp and 98%,94.3% respectively in diagnosis of neoplastic polyps.Conclusion Colorectal pit method has important clinical significance in judging the nature of the colorectal polyps lesions and determining tumor and non-neoplastic lesions and early small lesions.
出处
《宁夏医科大学学报》
2012年第11期1126-1129,F0003,共5页
Journal of Ningxia Medical University
基金
国家自然科学基金资助项目(30960370)
关键词
大肠息肉
染色放大内镜
腺管开口
组织病理
colorectal polyps
staining magnifying colonoscopy
pit
pathologica
