恶性溃疡的胃镜特征、活检取材数目与早期胃癌阳性率的关系

PROSPECTIVE EVALUATION OF FEATURES SUGGESTIVE OF MALIGNANT ULCER AND BIOPSY NUMBER IN THE DIAGNOSIS OF EARLY GASTRIC CARCINOMA

我们回顾了34例凹陷型早期胃癌病人的胃镜图像．发现其溃疡可有下述特征：溃疡边缘凹凸不平；溃疡口外展、边缘模糊；边缘出血；边缘皱襞异常，粘膜皱襞中断；溃疡面导常坏死；溃疡周围粘膜异常．有上述特征者早期胃癌阳性率高达76．3％，而对照组仅为0．1％（P＜0.001）．活检取材数目与阳性率的关系也密切．取材≤2块者与取材≥4块者．阳性率分别为61．5％和95．2％（P＜0．05）．

We analyzed the endoscopic features of 34 patients with excavated type early gastric cancer and found that the ulcers may pos sess these endoscopic features rough and uneven in the ulcer edge, extension of the ulcer crater that blurs the ulcer edge, bleed ing at the edge, abnormal folds at the mar gin, disruption of folds before they reach the crater, an unuually necrotic crater and ab normal mucosa surrounding the ulcer. The positive rate may reach 76. 3% if the ulcer possess one of the features or more, other wise, it's only 0. 1% (P<0. 001). Addition ally, the number of biopsies may affect the positive rate of early gastric cancers that were tested out. Four quadrant biopsies or more from inner margin and the center are usually appropriate The positive rate of which may reach 95- 2% otherwise it's only 61.5% if two biopsies or less (P<0. 05).