大肠癌与非癌病变粘膜面的立体显微镜观察

STEREOMICROSCOPIC OBSERVATION OF MUCOSAL SURFACE OF LARGE INTESTINAL CARCINOMA AND NON-MALIGNANT LESIONS

早期诊断大肠癌在我国是一个重要课题,应用放大大肠镜试图早期发现大肠癌及其他病变已有一些报道,但从病理学角度较系统的研究并不多见。我们在研究胃粘膜炎症性及细小癌性病变的基础上,应用立体显微镜并用色素法,观察大肠癌,腺瘤及慢性炎症粘膜面的亚肉眼形态特征,并与组织学进行对比研究,以探索上述各种病变的鉴别点,为放大大肠镜的临床实践提供病理形态学基础。

40 cases of large intestinal carcinoma,5 cases of papillary adenoma with malignantchange and 20 cases of tubular adenoma were observed under stereomicroscopy withpigment stains,and compared with histopathological changes. The results revealed thatthe tiny lesions of mucosal surface could be divided into 4 types: round hole type, ovoid-hole type, sulcus--gyrate type and irregular type. The round hole type belongs tonor-normal mucosa. The inflammatory lesions and tubular adenoma are mainly of both ovoidhole and sulcus-gyrate types, and the malignant lesions, of irregular type. The stereo-microscopio features of various types of malignant lesions were carefully described.This study would provide a pethological base in diagnosis of large intestinal diseases byusing amplified colonoscopy.