摘要
目的 评价腺管开口分型对诊断早期大肠癌及癌前病变的临床实用价值。方法 2 0 0 0年 11月～ 2 0 0 2年 8月结肠镜检查 4 176例次 ,采用内镜下黏膜染色技术 ,部分病变结合放大内镜及实体显微镜观察腺管开口分型 (pit分型 )并与病理诊断对照 ,pit分型采用工藤分型。 结果 75 2例患者发现大肠隆起、扁平等不同病变共 95 5个 ,共检出早期大肠癌 14例 ,进展期癌 2 0 9例 ,Ⅱa、Ⅱb、Ⅱc、Ⅱa +Ⅱc病变 76个。侧向发育型肿瘤 (LST型 )病变 4 3个 ,直径 16～ 110mm ,其中Ⅱ型 2个 ,ⅢL18个 ,Ⅳ 19个 ,ⅤA 型 1个 ,ⅤN 型 3个。非肿瘤性息肉以Ⅰ、Ⅱ型腺管开口为主 ,占 85 .4 % (30 3/ 35 5 ) ;而腺瘤性息肉则以Ⅲ、Ⅳ型腺管开口为主 ,占 86 .0 % (5 0 4 / 5 86 ) ;进展期癌均表现为黏膜腺管开口破坏无结构 ,为ⅤN 型 ;14例早期癌中有 8例腺管开口为Ⅴ型 ,其中ⅤA 型 2个 ,ⅤN 型 6个。结论 大肠腺管开口分型对于判断肿瘤性。
Objective To evaluate diagnostic value of pit pattern analysis on detection of early colorectal carcinoma. Methods 4176 patients were examined with colonoscopy and had the mucosal lesions stained with 0.4% indigo carmine, and part of them observed with magnifying endoscope and stereomicroscope, then compared the mucosal crypt patterns (the pit patterns Kudo classification) with pathologic diagnosis. Results There were 955 protruded and flat lesions on the large intestine mucosa in 752 patients, and among them there are 14 early cancers, 209 advanced cancers, 76Ⅱa、Ⅱb、Ⅱc、Ⅱa+Ⅱc lesions. We also found 43 laterally spreading tumors (LST) ranging from 16 to 110 mm in diameter, 2 for pit Ⅱ,18 for pit Ⅲ L, 19 for pit Ⅳ, 1 for pit Ⅴ A, 1 for Ⅴ N. The pit pattern of the most non neoplastic lesions was type Ⅰ or Ⅱ, which is about 85.4% (303/355), and the type of the adenomas was type Ⅲ or Ⅳ, about 86.0% (504/586). All the invasive carcinomas'pit patterns were type Ⅴ and there were 8 for type Ⅴ (2 Ⅴ A, 6Ⅴ N) among 14 early carcinomas. Conclusion Pit pattern analysis is a very important tool to determine the nature of lesions, which helps to decide the kinds of later therapeutic intervention.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2004年第2期78-82,共5页
Chinese Journal of Digestion
关键词
大肠癌
癌前病变
大肠黏膜病变
腺管开口
临床分型
Colorectal mucosal lesion
Pit pattern
Mucosal staining
Magnifying endoscope
Early colorectal cancer
