Tatsuta M, Iishi H, Okuda S, Oshima A, Taniguchi H
Department of Gastrointestinal Oncology, Center for Adult Diseases, Osaka, Japan.
Cancer. 1989 Apr 1;63(7):1415-20. doi: 10.1002/1097-0142(19890401)63:7<1415::aid-cncr2820630731>3.0.co;2-9.
The accuracy of gastrofiberscopic biopsy in diagnosis of gastric malignancies has been evaluated by studying operative and postmorten findings and clinical follow-up data in linkages at Osaka Cancer Registry, Japan, after an average of 7.7 years. Satisfactory data were obtained in follow-ups of all 1331 patients examined. There were only 31 (3.7%) false-negative diagnoses of malignancy among 858 patients diagnosed as having benign lesions, and only three (0.6%) false-positive diagnoses among 473 patients diagnosed as having malignant tumors. The false-negative diagnoses were most frequent in cases of elevated types of early cancer, advanced cancer of type 4 and leiomyosarcoma, or in cases located in the posterior wall and in the antrum. The three benign lesions that were diagnosed as malignant by biopsy were all associated with active ulceration, indicating that care is necessary in taking biopsy specimens of ulcerated lesions. From these findings the sensitivity and specificity of the gastrofiberscopic biopsy method for detection of gastric malignancies were calculated to be 93.8% and 99.6%, respectively, and the overall accuracy for all the patients was 97.4%. These results reconfirm that gastrofiberscopic biopsy is very useful for diagnosis of gastric malignancies.
在日本大阪癌症登记处，通过研究平均7.7年后的手术和尸检结果以及临床随访数据，评估了纤维胃镜活检对胃恶性肿瘤诊断的准确性。在对所有1331例接受检查的患者进行随访后，获得了令人满意的数据。在858例被诊断为良性病变的患者中，只有31例（3.7%）恶性肿瘤的假阴性诊断，在473例被诊断为恶性肿瘤的患者中，只有3例（0.6%）假阳性诊断。假阴性诊断在早期癌症隆起型、4型进展期癌症和平滑肌肉瘤病例中最为常见，或在位于后壁和胃窦的病例中最为常见。经活检被诊断为恶性的3例良性病变均与活动性溃疡有关，这表明在采集溃疡病变的活检标本时需要谨慎。根据这些发现，纤维胃镜活检方法检测胃恶性肿瘤的敏感性和特异性分别计算为93.8%和99.6%，所有患者的总体准确率为97.4%。这些结果再次证实纤维胃镜活检对胃恶性肿瘤的诊断非常有用。
