结直肠高级别上皮内瘤变89例临床病理分析

High-grade Colorectal Intraepithelial Neoplasia:A Clinicopathologic Study of 89 Cases

目的:探讨结直肠高级别上皮内瘤变的临床病理学特点和手术前后病理诊断的误差原因。方法:对89例结直肠高级别上皮内瘤变的临床病理学资料进行分析。结果:89例结直肠高级别上皮内瘤变发生率占同期结直肠活检诊断结直肠腺癌患者的24.7%。肿瘤好发部位以直肠最多,其次为乙状结肠和横结肠,降结肠和升结肠少见。术后病理诊断符合率为11.2%。结论:结直肠高级别上皮内瘤变术前与术后病理诊断存在较大的差异,应慎重对待。临床与病理加强联系,可望提高诊断率。

Objective To study the clinicopathological characteristics of high-grade colorectal intraepithelial neoplasia and analyze the source of diagnostic error before and after operations. Methods The clinical and pathologic data of 89 cases of high-grade colorectal intraepithelial neoplasia were analyzed. Results Eighty-nine cases of high-grade colorectal intraepithelial neoplasia took 24.7% of all colorectal adenocarcinoma examined in the same period.Most of them located in the rectum,some was in the sigmoid colon and transverse colon.A few was in the descending colon and ascending colon.The accordant rate of preoperative and postoperative pathologic result was 11.2%. Conclusions The pathologic results were quite different preoperatively and postoperatively,so that careful attention is necessary for clinicians in making a diagnosis.Close relationship of clinicians and pathologists in consideration and discussion is essential to raise the correct diagnosis rate of high-grade colorectal intraepithelial neoplasia.