摘要
背景:结直肠侧向发育型肿瘤(LST)与结直肠癌关系密切。目的:探讨色素内镜联合内镜黏膜切除术(EMR)对结直肠LST的临床诊疗价值。方法:纳入2009年7月～2012年2月于达县人民医院行结肠镜检查发现可疑病灶的患者2200例,对病灶内镜下喷洒0.4%靛胭脂行黏膜染色。对染色发现的LST,观察病灶大小并进行形态分型。对LST病灶行EMR或内镜分片黏膜切除术(EPMR),未能行EMR或EPMR者行内镜下活检。结果:黏膜染色后发现结直肠LST患者28例,共30个LST病灶。30个LST病灶中颗粒均一型14个(46.7%),结节混合型8个(26.7%),平坦隆起型5个(16.7%),假凹陷型3个(10.0%);行EMR19个(63.3%),行EPMR6个(20.0%),行内镜下活检5个(16.7%)。病理学检查示早期结直肠癌4个(13.3%),进展期结直肠癌3个(10.0%),腺瘤23个(76.7%)。结论:色素内镜可有效发现结直肠LST病灶。色素内镜联合EMR或EPMR根除LST病灶对早期结直肠癌的防治具有积极意义。
Background： Colorectal laterally spreading tumor （LST） has a close association with colorectal cancer. Aims： To investigate the clinical value of chromoendoscopy and endoscopic mucosal resection （EMR） in diagnosis and treatment of colorectal LST. Methods： A total of 2200 patients with suspected mucosal lesions under colonoscopy were enrolled from Jul. 2009 to Feb. 2012 at Daxian People＇ s Hospital. Indigo carmine （0.4%） was sprayed onto surface of the lesions for detecting and outlining the size and morphological type of LST. Then the LST lesions were treated with EMR, endoscopic piecemeal mucosal resection （EPMR） or endoscopic biopsy （if endoscopic resection was unavailable）. Results： A total of 30 colorectal LST lesions were found in 28 patients. Of the 30 LST lesions, 14 （46.7%） were classified as homogenous granular type, 8 （26.7%） as nodular mixed type, 5 （ 16.7% ） as flat-elevated type and 3 （ 10.0% ） as pseudo-depressed type. Nineteen lesions （63.3%） were treated with EMR, 6 lesions （20.0%） were treated with EPMR and 5 lesions （ 16.7% ） were treated with endoscopic biopsy. The pathological examination revealed that 4 lesions （ 13.3% ） were early colorectal cancer, 3 lesions （ 10. 0% ） were progressive colorectal cancer and 23 lesions （76.7%） were adenoma. Conclusions： Chromoendoscopy is effective for detecting colorectal LST lesions. Chromoendoscopy combined with EMR or EPMR for curing of LST lesions is of great significance in prevention and treatment of early colorectal cancer.
出处
《胃肠病学》
2013年第1期43-44,共2页
Chinese Journal of Gastroenterology
关键词
结直肠肿瘤
黏膜染色
内镜黏膜切除术
诊断
治疗
Colorectal Neoplasms
Mucosa Staining
Endoscopic Mucosal Resection
Diagnosis
Therapy
