结直肠癌活检病理诊断的临床研究

Clinical study of pathological biopsy in the diagnosis of colorectal cancer

目的探析结直肠癌活检病理诊断在结直肠癌临床确诊过程中的应用及其临床价值。方法选择我院2011年1月-2013年9月期间共收集到31例行内镜黏膜切除术患者展开研究,患者术前均进行肠镜病理活检,对比术后确诊结果,以此明确结直肠癌活检病理诊断敏感性、特异性。结果 EMR诊断结果为低分化腺癌19例、黏液细胞癌2例、黏液腺癌10例,术前活检病理诊断结果为低分化腺癌25例、黏液细胞癌4例、黏液腺癌1例、管状腺癌1例,黏液腺癌确诊率较低(P<0.05),比较有显著差异。以EMR诊断结果为基准,术前活检共22例确诊,9例漏诊,敏感性为71.0%(22/31),8例误诊,特异性为74.2%(23/31)。结论结直肠癌活检病理诊断在结直肠癌临床诊断中的应用具有较高敏感性,是重要确诊方法,应用放大色素内镜进行活检检查可进一步提高敏感性,实现尽早确诊,临床价值较高。

[Objective]To explore the application of pathological biopsy in the diagnosis of colorectal cancer and its clinical value. Methods： 31 cases of patients who received endoscopic mucosal resection in our hospital from January 2011 to September 2013 were selected as the study object. All of the patients received pathological biopsy before operation. The diagnostic results were compared to clarify the sensitivity and specificity of pathological biopsy in the diagnosis. Results： The EMR diagnosis showed that 19 cases of the patients suffered from low differentiated adenocarcinoma, two cases suffered from mucilaginous cell carcinoma and 10 cases suffered from of mucilaginous adenocarcinoma. The results of pathological biopsy before operation showed that 25 cases of the patients suffered from low differentiated adenocarcinoma, four cases suffered from mucilaginous cell carcinoma, one patient suffered from mucilaginous adenocarcinoma and one patient suffered from tubular adenocarcinoma. The confirmed diagnosis rate of mucilaginous adenocarcinoma was relatively low（P〈0.05） and there was a significant difference. With EMR diagnostic results for the benchmark, 22 cases were made a definite diagnosis but 9 cases missed diagnosis. The sensitivity was 71%（22/31）. Eight cases were misdiagnosed. The specificity was 74.2%（23/31）. Conclusion： The application of pathological biopsy in the diagnosis of colorectal cancer has high sensitivity and is an important diagnostic method. The application of magnifying chromo endoscopy to biopsy can further improve the sensitivity and can realize the early diagnosis and clinical value is higher.