73例早期胃癌内镜特点分析

Characteristic of early gastric cancer under endoscopy (73 cases)

摘要:

目的 探讨早期胃癌（EGC）内镜特点及诊断方法的实用性。方法 对73例EGC进行回顾性分析，对白光胃镜下黏膜异常表现，行色素胃镜及放大胃镜检查，根据腺管开口、微血管形态靶向活检送病理，病理明确癌变者行内镜下黏膜剥离术（ESD）或手术切除，术后病理作为最终诊断；记录整个检查过程中的所有表现及结果，综合分析。结果 73例发现病灶86处，其中9例有2处病变，2例有3处病变，白光胃镜下以0-Ⅱc型居多，占43.84%；腺管开口Ⅲ型23处、Ⅳ型44处，Ⅴ型19处；微血管形态规则型51处（59.30%）、不规则型29处（33.72%）、未发现微血管结构6处（6.98%）。普通白光胃镜与病理诊断完全符合率为60.46%（52/86）、基本符合率为72.09%（62/86），放大内镜与病理诊断完全符合率为93.02%（80/86）、基本符合率96.51%（83/86），两者相比差异有统计学意义（P <0.05）。结论 EGC内镜下具有特异性表现，根据这些表现可以加强对EGC识别能力，提高EGC诊治水平。

Abstract:

Objective To investigate the utility of endoscopic characteristic and diagnostic method in early gastric cancer (EGC). Methods The chromoendoscopy and magnifying endoscopy were retrospectively analyzed in 73 patients of EGC, endoscopic biopsy of the abnormal expression mucosa was done according to the surface pattern and microvascular pattern, the cancer was resected by ESD or surgical, the pathological diagnosis of the postoperative as the final diagnosis. To record and analyzed the results of the whole process. Results 86 lesions in 73 patients were examined with white light endoscopy, which included 9 patients with 2 lesions and 2 patient with 3 lesions, the type of 0-IIc was 43.84% .The pit patterns of 23 lesions were type Ⅲ, 44 lesions were type Ⅳand 19 lesions were type Ⅴ. The microvascular pattern of 51 lesions were regular (59.30%), 29 lesions were irregular (33.72%) and microvessel structure of 6 lesions wasn't found (6.98%). The coincidence rate in white light endoscopy and pathological diagnosis was 60.46% (52/86), basic coincidence rate was 72.09% (62/86). The complete coincidence rate in magnifying endoscopy and pathological diagnosis was 93.02% (80/86) and the basic rate was 96.51% (83/86), there were significant differences between in the diagnostic accuracy between the two groups methods, P < 0.05. Conclusion The medical imaging characteristics of EGC by endoscopy may be found, we can to improve the recognition ability and the level of diagnosis of EGC.