与内镜黏膜下剥离术相比，传统钳取活检的诊断准确性
The Diagnostic Accuracy of Conventional Forceps Biopsy Compared to ESD.
作者信息
Wu Shimin, Zhu Xinjian, Xiang Lijuan, Chen Jianqiang, Chen Chunxiao
机构信息
Department of Gastroenterology, the First Affiliated Hospital, College of Medicine, Zhejiang University, No.79 Qingchun Road, Hangzhou310003, China.
Shaoxing shangyu people's hospital, Shaoxin, China.
出版信息
Open Med (Wars). 2017 Aug 12;12:261-265. doi: 10.1515/med-2017-0039. eCollection 2017.
OBJECTIVE
conventional forceps biopsy (CFB) is the most popular way to screen for gastric epithelial neoplasia (GEN). Our study aimed to compare the diagnostic accuracy between conventional forceps biopsy and endoscopic submucosal dissection (ESD).
METHODS
105 patients diagnosed GEN finally undertook ESD in our hospital were enrolled. We retrospectively assessed the characteristics of pathological results of CFB and ESD.
RESULTS
The overall pathologic concordance rate between the CFB and ESD specimens was 68.57%. 55 cases of CFB maintained low-grade intraepithelial neoplasia (LGIN) under ESD,18 cases (23.1%) diagnosis for high-grade intraepithelial neoplasia (HGIN), 5 cases (6.4%) diagnosis for cancer. Moreover, 10 cases of CFB maintained HGIN under ESD. Lesions with surface hyperemia (44.4% vs. 27.54%) or surface ulcer (57.14% vs.26.76%) were more likely to cancerate (P<0.05).
CONCLUSION
endoscopic biopsy in the diagnosis of low-grade intraepithelial neoplasia, may exist or progression to high-grade intraepithelial neoplasia, some may have cancer, should take active treatment measures.
目的
传统钳取活检（CFB）是筛查胃上皮内瘤变（GEN）最常用的方法。本研究旨在比较传统钳取活检与内镜黏膜下剥离术（ESD）之间的诊断准确性。
方法
纳入我院最终接受ESD治疗的105例诊断为GEN的患者。我们回顾性评估了CFB和ESD的病理结果特征。
结果
CFB与ESD标本的总体病理符合率为68.57%。55例CFB在ESD下维持低级别上皮内瘤变（LGIN），18例（23.1%）诊断为高级别上皮内瘤变（HGIN），5例（6.4%）诊断为癌症。此外，10例CFB在ESD下维持HGIN。有表面充血（44.4%对27.54%）或表面溃疡（57.14%对26.76%）的病变更易癌变（P<0.05）。
结论
内镜活检诊断为低级别上皮内瘤变者，可能存在或进展为高级别上皮内瘤变，部分可能已发生癌变，应采取积极的治疗措施。
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