结肠息肉活检术与全瘤切除术病理诊断的对比

Comparison of pathological diagnosis between tissue biopsy and endoscopic resection of colon polyps

目的:通过分析结肠息肉内镜下活检术与全瘤切除术病理诊断的差异,探究两者存在差异的主要影响因素及提高活检术准确性的方法.方法:回顾性分析在青岛大学附属医院行内镜下息肉切除术的142例患者的资料,共发现161枚息肉(结肠息肉直径≥1.0 cm),评估其活检病理与全瘤切除术病理间差异,并对造成差异的主要影响因素做相关分析.结果:结肠息肉活检病理诊断与切除术后病理诊断一致率为51%(82/161);不一致率为49%(79/161).息肉直径为影响活检术准确性的主要因素(1.0-1.9 cm,病理不一致率为42%;≥2.0 cm,不一致率为65%,差别有统计学意义).结论:与全瘤切除术比较,活检术的病理诊断结果准确性低,尤其见于直径较大息肉.

AIM： To evaluate the discrepancy of pathological diagnosis between tissue biopsy and resection of colon polyps, and explore the main influencing factors to improve the accuracy of biopsy methods.METHODS： This study retrospectively analyzed 161 colon polyps from 142 patients who underwent polyp resection at our hospital （patients with polyps of at least 1.0 cm in diameter）. The discrepancy in the pathological diagnosis betwqen endoscopic biopsy and resected tissues of colon polyps was evaluated. Factors that contributed to such discrepancy were analyzed. RESULTS： The concordance rate of pathological diagnosis between endoscopic biopsy and resection was 51% （82/161）, and the discrepancy rate was 49% （79/161）. The lesion size was the main factor that undermined the diagnostic accuracy of biopsy （1.0-1.9 cm, the discrepancy rate was 42%; ≥2.0 cm, the discrepancy rate was 65%; P 〈 0.05）.CONCLUSION： The pathological diagnosis by endoscopic biopsy of colon polyps is of limited accuracy, especially in larger diameter polyps.