评估内镜活检和刷检细胞学检查对食管和胃癌的特异性价值。
Evaluation of specific value of endoscopic biopsies and brush cytology for malignancies of the oesophagus and stomach.
作者信息
Witzel L, Halter F, Grétillat P A, Scheurer U, Keller M
出版信息
Gut. 1976 May;17(5):375-7. doi: 10.1136/gut.17.5.375.
The value of multiple biopsies and brush cytology at oesophago-gastroscopy was assessed in relation to macroscopy and localization on 100 verified tumours in a prospective study. The cumulative accuracy achieved was 96%. This was significantly better (P less than 0-01) than that of biopsy (83%) and of cytology (85%). While the reliability of both procedures was not significantly different in malignancies of the oesophagus, the gastric body, and the antrum, cytoloty was significantly more accurate in cancers of the cardia (90% and 55% respectively, P less than 0-05). Cytology was also more reliable in stenosing tumours (92%/72%,P less than 0-05). In polypoid malignancies a positive but not significant trend was found in favour of multiple biopsies (94%/64%). One of the two early cancers was only diagnosed by cytology. The results confirm the high diagnostic accuracy of multiple endoscopic biopsies combined with brush cytology and demonstrate the value of cytology in stenosing tumours, especially in those of the cardia.
在一项前瞻性研究中，针对100例经证实的肿瘤，评估了食管胃镜检查时多次活检和刷检细胞学检查相对于大体检查和定位的价值。所达到的累积准确率为96%。这显著优于活检（83%）和细胞学检查（85%）（P<0.01）。虽然在食管癌、胃体癌和胃窦癌中，这两种检查方法的可靠性没有显著差异，但在贲门癌中，细胞学检查的准确性显著更高（分别为90%和55%，P<0.05）。在狭窄性肿瘤中，细胞学检查也更可靠（92%/72%，P<0.05）。在息肉样恶性肿瘤中，发现多次活检有阳性但不显著的趋势（94%/64%）。2例早期癌症中有1例仅通过细胞学检查得以诊断。结果证实了多次内镜活检联合刷检细胞学检查具有较高的诊断准确性，并证明了细胞学检查在狭窄性肿瘤，尤其是贲门部狭窄性肿瘤中的价值。
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