Kim Kyoung Mee, Park Cheol Keun
Department of Pathology, Samsung Seoul Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2010 Oct;56(4):214-9. doi: 10.4166/kjg.2010.56.4.214.
It is widely accepted that endoscopic submucosal dissection (ESD) is an important treatment option for cases of early gastric carcinoma where the probability of lymph node metastasis is very low. The resected ESD specimens are carefully examined by serial sections at 2 mm intervals, and if pathology reveals submucosal invasion more than 500 μm and/or lymphovascular invasion, or if the resection margin is involved by the tumor, surgery is recommended. In this point of view, thorough pathologic examination and reporting the accurate pathologic diagnosis of ESD specimen is very important. The diagnostic approach and pitfalls in the diagnosis of ESD specimen are reviewed.
内镜黏膜下剥离术(ESD)作为早期胃癌淋巴结转移概率极低病例的重要治疗选择,已被广泛接受。切除的ESD标本以2毫米间隔进行连续切片仔细检查,若病理显示黏膜下浸润超过500微米和/或存在淋巴管浸润,或肿瘤累及手术切缘,则建议进行手术。从这一角度来看,对ESD标本进行全面的病理检查并报告准确的病理诊断非常重要。本文对ESD标本的诊断方法及诊断中的陷阱进行了综述。