大肠腺瘤的形态特征和染色后内镜检查对腺瘤的诊断价值

Morphologic characteristics of large intestine adenoma and diagnostic value of homoendoscope on large intestine adenoma

目的探讨大肠腺瘤的形态特征和染色后内镜检查对大肠腺瘤的诊断价值。方法分析1872例大肠镜检查的病人，并对其中240例肉眼未发现明显病变病人的直肠再用0．5％美兰液染色后内镜检查，同时进行活检组织病理学检查。结果发现腺瘤或息肉者74例，总共132枚息肉，其中大肠腺瘤84枚，增生性息肉25枚，炎性息肉23枚。在对肉眼未发现明显病变的240例病人中直肠再用0．5％美蓝液染色进行观察，发现黏膜改变31例，其中4例为稍隆起型、23例为平坦型、4例为凹陷型。组织学检查18例为炎性增生，13例为腺瘤。结论大肠镜检查是发现大肠腺瘤的重要方法，染色后内镜检查可发现肉眼不易发现的病变，明显提高诊断的准确性，值得进一步推广应用。

Objective To study the morphologic characteristics of large intestine adenoma and diagnostic value of homoendoscope on large intestine adenoma. Method 1872 patients were conducted and analysed by total colonoscopy, and 240 patients that obvious foci were not found in rectum were stained with 0.5% methylthioninium chloride under total colonoscopy. All patients were pathologically diagnosed by biopsy. Results In 1872 patients conducted by total colonoscopy, 74 patients with adenoma and polypi were found. Total number of the polypi were 132, and 84 were large intestine adenoma, 25 were proliferative polypi and 23 were inflammatory polypi. In 240 patients that obvious foci were not found in rectum, 31 were adenoma. In 31 patients with adenoma, 4 were slight protrude type, 23 were flat type, and 4 were depressed type. Pathologically, 18 were inflammatory proliferation, and 13 were adenoma. Conclusions Examination of total colonoscopy is an important method of detecting large intestine adenoma. Homoendoscope might find the foci that could be not detected by naked eye and deserve further clinical spread and use.