内镜小容量活检钳可提高胃不确定肿瘤的病理诊断率。

Endoscopic small-capacity forceps increase the pathological diagnosis of gastric indefinite neoplasia.

作者信息

Matsuo Yasumasa, Yasuda Hiroshi, Kato Masaki, Kiyokawa Hirofumi, Ozawa Midori, Sato Yoshinori, Ikeda Yoshiko, Ozawa Shun-Ichiro, Yamashita Masaki, Fujino Takashi, Yamamoto Hiroyuki, Takagi Masayuki, Itoh Fumio

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan.

Department of Pathology, St. Marianna University School of Medicine, Kanagawa, Japan.

出版信息

Turk J Gastroenterol. 2018 Jul;29(4):481-487. doi: 10.5152/tjg.2018.17347.

DOI:10.5152/tjg.2018.17347

PMID:30249564

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6284649/

Abstract

BACKGROUND/AIMS: A definitive biopsy-based diagnosis of gastric cancer is sometimes difficult, and some cases are pathologically diagnosed as gastric indefinite neoplasia (GIN). The most appropriate forceps size for gastric biopsy has yet to be determined. In this study, we investigated the relation between the forceps size and the frequency of GIN diagnosis.

MATERIALS AND METHODS

The records of patients from two historical groups were reviewed. The first group comprised patients evaluated during the period when standard biopsy forceps (StF) were used (April 2010-March 2011), and the second group comprised patients evaluated during the period when small biopsy forceps (SmF) were used (April 2011-March 2013). Patients in whom GIN lesions were diagnosed with biopsy were identified, and pertinent data were compared between the two groups of patients.

RESULTS

Among the 8,420 patients who underwent esophagogastroduodenoscopy (EGD) during the first period, 2,584 (30.7%) underwent gastric biopsy with StF. Among the 15,968 patients who underwent EGD during the second period, 4,204 (26.3%) underwent gastric biopsy with SmF. GIN was diagnosed in a significantly greater number of patients in the SmF group than in the StF group (52 [1.25%] vs. 19 [0.73%]; p=0.048). The mean minor-axis lengths of the biopsy samples were 1.50±0.50 mm and 1.38±0.40 mm in the StF group and the SmF group, respectively, with the SmF group samples tending to be shorter (p=0.088).

CONCLUSION

Because the SmF use may increase the rate of GIN diagnosis, the use of SmF with a standard-caliber endoscope should be avoided.

摘要

背景/目的：基于活检对胃癌进行明确诊断有时存在困难，部分病例在病理上被诊断为胃不确定肿瘤（GIN）。目前尚未确定最适合胃活检的活检钳大小。在本研究中，我们调查了活检钳大小与GIN诊断频率之间的关系。

材料与方法

回顾了两个历史组患者的记录。第一组包括在使用标准活检钳（StF）期间（2010年4月至2011年3月）接受评估的患者，第二组包括在使用小活检钳（SmF）期间（2011年4月至2013年3月）接受评估的患者。确定经活检诊断为GIN病变的患者，并比较两组患者的相关数据。

结果

在第一阶段接受食管胃十二指肠镜检查（EGD）的8420例患者中，2584例（30.7%）使用StF进行了胃活检。在第二阶段接受EGD的15968例患者中，4204例（26.3%）使用SmF进行了胃活检。SmF组诊断为GIN的患者数量明显多于StF组（52例[1.25%]对19例[0.73%]；p=0.048）。StF组和SmF组活检样本的平均短轴长度分别为1.50±0.50mm和1.38±0.40mm，SmF组样本往往更短（p=0.088）。