Dekker W, Tytgat G N
Gastroenterology. 1977 Oct;73(4 Pt 1):710-4.
The accuracy of fiberendoscopy with directed biopsy in the detection of upper intestinal malignancies has been evaluated by studying the operative or postmortem findings or the clinical follow-up data after at least 1 year and, for relevant lesions, after 2 or 3 years. Of 1005 patients examined, a satisfactory follow-up was obtained in 990. There turned out to be no false-positive diagnoses of malignancy in the 167 patients diagnosed fiberendoscopically to harbor an upper intestinal malignancy, and only two false-negative diagnoses in the fiberendoscopically benign group. Seven of the 135 adenocarcinomas of the stomach turned out to be early gastric cancers. The two missed malignancies were interpreted initially as benign gastric ulcers. The over-all endoscopic-bioptic accuracy rate calculated for all patients amounts to 99.8%. Such a high accuracy rate can only be reached provided high numbers of biopsies are taken, and particularly at least 10 of gastric ulcers and of suspicious lesions. Endoscopy by itself is not sufficiently reliable in determining the nature of the lesion. Indeed an incorrect endoscopic interpretation was made in 7.3% of the ulcerous lesions, and in 8.2% of them no firm conclusion could be reached.
通过研究手术或尸检结果，或至少1年的临床随访数据，以及相关病变2年或3年后的随访数据，对纤维内镜引导活检在上消化道恶性肿瘤检测中的准确性进行了评估。在接受检查的1005例患者中，990例获得了满意的随访结果。在167例经纤维内镜诊断为上消化道恶性肿瘤的患者中，没有出现恶性肿瘤的假阳性诊断，在纤维内镜诊断为良性的组中只有两例假阴性诊断。135例胃腺癌中有7例为早期胃癌。漏诊的两例恶性肿瘤最初被诊断为良性胃溃疡。所有患者的内镜活检总体准确率为99.8%。只有在进行大量活检的情况下，尤其是对胃溃疡和可疑病变至少进行10次活检，才能达到如此高的准确率。内镜检查本身在确定病变性质方面不够可靠。实际上，7.3%的溃疡性病变存在内镜诊断错误，8.2%的病变无法得出明确结论。
