摘要
目的对胃黏膜上皮内瘤变(IEN)患者进行定期胃镜随访,寻找有效提高临床早期胃癌检出率的方法。方法收集2013年1月—2017年12月经胃镜取活组织病理学检查诊断为胃黏膜IEN的患者326例,其中低级别IEN(LGIEN)289例,高级别IEN(HGIEN)37例。LGIEN患者进行定期随访、复查胃镜,并在病灶处取活组织进行病理学检查,若进展为胃癌或有确切病灶的HGIEN,则行内镜黏膜下剥离术、腹腔镜手术或外科治疗;HGIEN患者直接行内镜黏膜下剥离术、腹腔镜手术或外科治疗。将切除的标本经病理学检查后进行胃癌分期。结果 326例胃黏膜IEN患者中共检出胃癌50例,占15.34%;其中早期胃癌45例,进展期胃癌5例。289例LGIEN患者平均随访(22.32±15.32)个月,平均接受胃镜检查(3.92±1.47)次,共检出胃癌20例(6.92%),其中早期胃癌19例。37例HGIEN患者中共检出胃癌30例(81.08%),其中早期胃癌26例(70.27%)。结论对胃黏膜IEN患者定期随访胃镜能提高胃癌的早期诊断率。
Objective To improve the detection rate of early gastric cancer by following the patients with gastric intraepithelial neoplasia(IEN)with gastroscopy at regular intervals.Methods A total of 326 patients with gastric IEN,including 289 with low grade IEN (LGIEN)and 37 with high grade IEN (HGIEN)confirmed byendoscopic biopsy from January 2013 to December 2017 were enrolled in this study.The patients with LGIENreceived regular follow-ups,gastroscopy,pathological biopsy and treated by endoscope or surgery when necessary.Meanwhile,the patients with HGIEN received treatment by endoscopy or surgery.The patients with gastric cancers were grouped by TNM staging by pathological examination.Results Fifty patients(15.34%)were eventually diagnosed with gastric cancer,including 45early gastric cancers and 5advanced gastric cancers.An average of(3.92±1.47)endoscopic follow-ups in period of(22.32±15.32)months were done in 289 LGIEN patients,in which gastric cancer was detected in 20 patients(6.92%),and 19patients were diagnosed with earlycancer.In 37 HGIEN patients,gastric cancer was detected in 30 patients (81.08%),and 26 patients were diagnosed with early cancer(70.27%).Conclusion Regular follow-up and repeated biopsy may effectively improve the detection rate of early gastric cancer in gastric IEN patients.
作者
杨翠萍
吴巍
严晓伟
项明
陈平
罗芳秀
袁晓琴
许兰涛
吴云林
YANG Cuiping;WU Wei;YAN Xiaowei;XIANG Ming;CHEN Ping;LUO Fangxiu;YUAN Xiaoqin;XU Lantao;WU Yunlin(Department of Gastroenterology,Ruijin North Hospital, Shanghai Jiaotong University School of Medicine,Shanghai 201801,China)
出处
《上海医学》
CAS
北大核心
2018年第11期667-671,共5页
Shanghai Medical Journal
关键词
胃肿瘤
胃黏膜上皮内瘤变
早期胃癌
定期随访
筛查
Stomach neoplasms
Gastric intraepithelial neoplasia
Early gastric cancer
Regular followup
Screening
