纤维内镜活检胃黏膜诊断胃癌的临床病理分析

Clinicopathologic analysis of gastric carcinoma diagnosis by fibergastroscopy mucosa biopsy

目的:探讨纤维内镜活检查出胃癌的检出率及胃黏膜活检病理诊断中存在的问题。方法:对我科近三年胃黏膜活检1669例标本中诊断为胃癌的病理诊断结果进行回顾性分析。结果:诊断胃癌病例为148例,检出率为8.9%,年龄16-86岁,其中8例因需鉴别诊断、肿瘤组织量少等原因初诊为高级别异型增生可疑癌变或高级别异型增生,后经再次取材或胃切除手术后诊断为胃癌;2例初诊漏诊,后经复片后诊断为胃癌;所有胃黏膜活检病理诊断结果中有1例初诊为未分化胃癌,后行胃切除手术后修正诊断为恶性淋巴瘤。结论:纤维内镜对胃癌的检出具有重要价值,是一种非常有效的检查方法;胃黏膜活检病理诊断虽常见,但实际诊断中仍存在不少问题。

Objective：To study the detection rate for gastric carcinoma by endoscopy mucosa biopsy. Methods： Data of 1669 cases of gastric biopsy specimens were analyzed retrospectively. Results： Among1669 cases 148 cases wrer diagnosed as gastric cancer,and the detection rate was 8.9% ; the age ranged from 16 to 86; 8 of the 148 cases were preliminary diagnosed as high - level dysplasia. Two cases were missed and subsequently re - diagnosed as gastric cancer;and there was one case who was fristly diagnosed as undifferentiated gastric cancer while was revised as malignant lymphoma after surgery. Conclusion： Fibergastroscope is an effective examniation and useful for the diagnosis of gastric carcinoma; there are many problems in pathologic diagnosis of gastric mucosa biopsy.