摘要
目的探讨胃癌术前胃镜活检病理与术后病理诊断之间的差异,为提高临床诊断率,临床治疗提供依据。方法选择本院2018年1月至2019年4月收治的行胃大部分切除术的疑似胃癌患者80例临床资料,所有患者手术前接受胃镜活检病理,并在术后行病理诊断,其中术后病理诊断作为此次诊断的"金标准",统计术前胃镜活检情况,分析术前胃镜活检的敏感性、特异性、准确性,并对比两种病理检验下,病理类型和分化程度的差异。结果术前胃镜活检病理灵敏度为94.20%,特异度为90.91%,准确度为93.75%,阳性预测值为98.48%(阴性预测值71.43%。一致性分析,两种检验方式一致性良好,Kappa=0.811。术前胃镜活检病理结果与术后病理结果比较,不同病理分型胃癌诊断差异均无统计学意义(P>0.05)。但术前胃镜活检病理显示病理分化43.75%,与术后病理结果比较显示差异有统计学意义(P<0.05)。结论胃癌术前胃镜活检与术后病理诊断结果具有一定的差异,但术前胃镜活检的敏感性较高,阳性预测值较好,用于胃癌早期的诊断与防控措施的制定可提供依据,临床应用价值显著。
Objective To explore the difference between preoperative gastroscopic biopsy pathology and postoperative pathological diagnosis of gastric cancer,so as to provide basis for improving clinical diagnosis rate and clinical treatment.Methods The clinical data of 80 suspected gastric cancer patients who underwent subtotal gastrectomy in our hospital from January 2018 to April 2019 were selected.All patients received gastroscopy biopsy pathology before operation and underwent pathological diagnosis after operation.The postoperative pathological diagnosis was taken as the"golden standard"for this diagnosis.The preoperative gastroscopy biopsy was counted,and the sensitivity,specifi city and accuracy of preoperative gastroscopy biopsy were analyzed.The difference of pathological type and differentiation degree under the two pathological examinations were compared.Results The pathological sensitivity,specifi city,accuracy,positive predictive value and negative predictive value of preoperative gastroscopy biopsy were 94.20%,90.91%,93.75%,98.48%and 71.43%,respectively.Consistency analysis showed that the two test methods had good consistency,Kappa=0.811.Compared with the pathological results of preoperative gastroscopy biopsy and postoperative pathology,there was no signifi cant difference in the diagnosis of gastric cancer of different pathological types(P>0.05).However,preoperative gastroscopy biopsy showed pathological differentiation of 43.75%,which was statistically signifi cant compared with postoperative pathological results(P<0.05).Conclusion Preoperative gastroscopy biopsy and postoperative pathological diagnosis of gastric cancer have certain differences,but preoperative gastroscopy biopsy has higher sensitivity and better positive predictive value,which can provide basis for early diagnosis and prevention and control measures of gastric cancer and has signifi cant clinical application value.
作者
牛蕾
NIU Lei(Department of Pathology,Fuxin Central Hospital,Fuxin 123000,China)
出处
《中国医药指南》
2020年第18期96-97,共2页
Guide of China Medicine
关键词
胃癌
胃镜活检
术后病理
敏感度
阳性预测值
Gastric cancer
Gastroscopy biopsy
Postoperative pathology
Sensitivity
Positive predictive value
