内镜下黏膜切除术治疗结肠癌前病变的动态病理学观察

Pathologic Progress of Endoscopic Mucosal Resection for Precancerous Lesions of the Colon

目的探讨预防结肠癌的发生和发展的方法。方法185例结肠腺瘤患者经内镜下黏膜切除术并对组织进行p53蛋白免疫组织化学检测。结果在75处重度不典型增生的黏膜内,p53蛋白阳性40处(53.33%),其中20处经内镜下黏膜切除术治疗,治愈3处(15.00%),好转10处(50.00%),总有效率为65.00%。对照组好转2处(8.0%),两组总有效率比较差异有显著意义(P<0.01)。结论内镜下黏膜切除术能有效切除结肠癌前病灶,预防结肠癌的发生和发展。

Objective To explore the methods of prevention of colon cancer. Methods 185 patients with the colon adenoma diagnosed endoscopically were endoscopic resection. Severedysplasia cases were prepared immunohistochemieally for p53 protein study. The EMR was performed to these severe dysplasia with p53 protein-positive mucosa. Results There were 75 areas with severe dysplasias. Expression of p53 was found in 40 areas（53.33%）. EMR was performed to 20 areas.3 area （15.00%） was cured, 10 areas （50.00%） were improved.Total effective rate was 65.00%.In the contral group, 2 areas were improved. Total effective rate was 10.0%.Difference of effective rates is statistically significant. Conclusion EMR can reseet the colon precancerous lesions effectively. It seemed feasible to prevent to the progressive of colon cancer.