食管早癌及癌前病变内镜黏膜下剥离术前后病理差异分析

发布时间：2018-04-18 08:38

本文选题：内镜黏膜下剥离术 + 病理　；参考：《苏州大学》2015年硕士论文

【摘要】：目的:比较分析内镜黏膜下剥离术前后病理变化影响因素,初步探讨内镜黏膜下剥离术在食管早癌及癌前病变中的诊断价值。方法:在研究期间,共发现白光内镜下活检提示食管高级别上皮内瘤变的病灶67例。所有患者均接受内镜黏膜下剥离术,并在显微镜下观察所切除标本。根据术前和术后病理结果分为一致组和非一致组,以及术后病理较之活检结果相同组和升高组。比较分析年龄、性别、病灶位置、长度、标本大小、大体分型、饮酒史等可能预测ESD术后病理因素。结果:活检病理诊断与术后病理诊断相比,44.78%(30/67)诊断相符,46.27%(31/67)诊断不足,8.96%(6/67)的病灶诊断过度。术前术后病理一致组及ESD术后病理升高组相比,性别、病灶位置、标本大小及大体分型等有统计学差异。结论:男性和/或病灶较宽和/或非食管中段病灶和/或浅表凹陷型病变其活检结果可能诊断不足。内镜黏膜剥离术有诊断价值,能相对客观地评价病理性质,并为进一步治疗提供依据。
[Abstract]:Objective: to compare and analyze the influencing factors of pathological changes before and after endoscopic submucosal dissection, and to explore the diagnostic value of endoscopic submucosal dissection in early esophageal carcinoma and precancerous lesions.Methods: during the study, 67 cases of high grade intraepithelial neoplasia of esophagus were detected by white light endoscopy biopsy.All patients underwent endoscopic submucosal dissection and the specimens were observed under microscope.According to the preoperative and postoperative pathological results, the patients were divided into consistent group and non-consistent group, as well as the same group and elevated group compared with biopsy results.Age, sex, location, length, size, gross classification and history of alcohol consumption may predict pathological factors after ESD.Results: compared with the postoperative pathological diagnosis, the pathological diagnosis of biopsy was consistent with the diagnosis of 44.78% 30 / 67 (46.27% / 67).There were significant differences in sex, location of lesion, size of specimen and gross type between the same group of preoperative and postoperative pathology and the group of histopathologic elevation after ESD.Conclusion: the biopsy results of male and / or lesion with wider and / or non-esophageal lesions and / or superficial concave lesions may be under-diagnosed.Endoscopic mucosal dissection has diagnostic value and can objectively evaluate pathological properties and provide basis for further treatment.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.1

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