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[内镜检查中良性与恶性溃疡鉴别诊断的有效性]

[Effectiveness of differential diagnosis of benign and malignant ulcers at endoscopy].

作者信息

Gurin N N, Logunov K V

出版信息

Ter Arkh. 1998;70(4):37-40.

PMID:9612900
Abstract

AIM

Assessment of efficacy of differential diagnosis between benign and malignant lesions in gastric mucosa by means of endoscopy.

MATERIALS AND METHODS

Morphological verdicts upon investigation of operative specimens were compared to findings at preoperative duodenofibrogastroscopy with spot biopsy in 326 patients operated for gastric ulcer. The number of discrepancies between the endoscopic and morphological diagnoses enabled estimation of endoscopy + biopsy efficiency in identification of the ulcer malignancy.

RESULTS

The number of diagnostic errors made on malignant or benign nature of ulcer at endoscopic and biopsy investigations is rather big, i.e. at least 12% for both false negative and false positive hypophyses. The overall diagnostic efficacy of endoscopy in detection of the disease lies within 65-80%.

CONCLUSION

Reliability of endoscopic identification including biopsy of malignant nature of gastric ulcers is not very high. Real sensitivity of this method in detection of ulcers undergoing malignant transformation reaches 76-78%.

摘要

目的

通过内镜评估胃黏膜良性和恶性病变的鉴别诊断效果。

材料与方法

将326例因胃溃疡接受手术的患者手术标本检查的形态学诊断结果与术前十二指肠纤维胃镜检查及取点活检的结果进行比较。内镜诊断与形态学诊断之间的差异数量有助于评估内镜检查+活检在识别溃疡恶性病变方面的效率。

结果

在内镜检查和活检中,对溃疡的恶性或良性性质做出的诊断错误数量相当大,即假阴性和假阳性假设均至少为12%。内镜检查在疾病检测中的总体诊断效果在65%-80%之间。

结论

包括对胃溃疡恶性性质进行活检在内的内镜识别可靠性不是很高。该方法在检测发生恶性转化的溃疡方面的实际敏感性达到76%-78%。

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