摘要
目的探讨快速现场评价技术(ROSE)联合常规消化内镜(电子胃镜或结肠镜)活组织检查(活检)能否提高消化道占位性病变的诊断正确率及减少相关并发症的发生率.方法连续纳入影像学或消化内镜发现消化道占位性病变的患者.将上消化道占位性病变患者随机分为2组:常规电子胃镜组(A组,109例)、ROSE+常规电子胃镜组(B组,109例);下消化道占位性病变患者亦随机分为2组:常规电子结肠镜组(C组,421例)、ROSE+常规电子结肠镜组(D组,421例).比较各组间活检诊断正确率及并发症发生率.结果A组活检诊断正确率80.73%(88/109)与B组活检诊断正确率88.99%(97/109)差异无统计学意义(P>0.05),但B组恶性肿瘤亚组活检诊断正确率100%(26/26)高于A组恶性肿瘤亚组活检诊断正确率82.61%(19/23),差异有统计学意义(P<0.05);C组活检诊断正确率78.86%(332/421)与D组活检诊断正确率82.66%(348/421)差异无统计学意义(P>0.05),但D组恶性肿瘤亚组活检诊断正确率96.61%(57/59)高于C组恶性肿瘤亚组活检诊断正确率81.40%(35/43),差异有统计学意义(P<0.05);各组均未发生大出血、消化道穿孔严重并发症.结论将ROSE与常规消化内镜结合起来,可提高消化道恶性肿瘤的活检诊断正确率.
Objective To discuss whether the rapid on-site evaluation(ROSE)combined with routine gastrointestinal endoscopy(electronic gastroscope or colonoscope)biopsy can increase the diagnostic accuracy of digestive tract space-occupying lesions and decrease the incidence rate of related complications.Methods Patients diagnosed with digestive tract space-occupying lesions detected by radiograph or gastrointestinal endoscopy in our hospital were recruited in this study.Patients with space-occupying lesions in the upper gastrointestinal tract were randomly divided into two groups:routine electronic gastroscope(group A,n=109)and ROSE+routine electronic gastroscope groups(group B,n=109).Patients with spaceoccupying lesions in the lower gastrointestinal tract were also randomly assigned into two groups:routine electronic colonoscope(group C,n=421)and ROSE+routine electronic colonoscope groups(group D,n=421).The diagnostic accuracy of biopsy and the incidence of complications were statistically compared between two groups.Results The diagnostic accuracy of biopsy in group A was 80.73%(88/109),which did not significantly differ from 88.99%(97/109)in group B(P>0.05).However,the diagnostic accuracy of biopsy in the malignant tumor subgroup of group B was 100%(26/26),significantly higher than 82.61%(19/23)in the malignant tumor subgroup of group A(P<0.05).The diagnostic accuracy of biopsy in group C was 78.86%(332/421),which did not significantly differ from 82.66%(348/421)in group D(P>0.05).Nevertheless,the diagnostic accuracy of biopsy in the malignant tumor subgroup of group D was 96.61%(57/59),significantly higher compared with 81.40%(35/43)in the malignant tumor subgroup of group C(P<0.05).No serious complications,such as massive hemorrhage or digestive tract perforation,were observed in each group.Conclusion ROSE combined with routine gastrointestinal endoscopy can increase the diagnostic accuracy of biopsy for digestive tract malignant tumors.
作者
覃善君
张朝顺
杨新魁
钟永锋
Qin Shanjun;Zhang Chaoshun;Yang Xinkui;Zhong Yongfeng(Department of Digestive System Diseases,Zhongshan Chenxinghai Hospital,Zhongshan 528415,China)
出处
《新医学》
2020年第4期294-298,共5页
Journal of New Medicine
基金
中山市医学科研项目(2017A020030)。
关键词
消化道占位性病变
消化内镜
快速现场评价技术
Digestive tract space-occupying lesion
Gastrointestinal endoscopy
Rapid on-site evaluation
