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早期胃癌检出情况及其内镜下特征分析(附43例报道) 被引量:8

Detection of early gastric cancer and analysis of its endoscopic characteristics(43 cases)
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摘要 目的调查分析浙江省余姚地区早期胃癌(EGC)的检出情况,探讨EGC内镜下特点及病理学特征。方法回顾性收集2016年度宁波大学医学院附属阳明医院消化内镜中心行胃镜检查患者的病例资料,筛选统计出EGC(检查时发现并经病理确诊)的检出率,并对发现的43例EGC患者(47处病灶)的临床资料进行回顾性总结,对比分析其普通白光内镜下特征、窄带成像(NBI)放大内镜下特征及病理学特征。结果 EGC的总体检出率为0.23%(43/18 534),占胃癌总检出例数的24.71%(43/174)。本研究发现EGC以发生在胃窦部最常见(36.17%,17/47),病灶大小以>1.0 cm为主(68.09%,32/47),内镜下形态以0-Ⅱc型病灶为主,占55.32%(26/47)。白光内镜下表现为黏膜发红35处(74.47%,35/47)、边界清晰43处(91.49%,43/47)、表面不规则42处(89.36%,42/47)、黏膜萎缩和(或)肠上皮化生39处(82.98%,39/47)、边缘毛刺状17处(36.17%,17/47)、白色不透明物质(WOS)8处(17.02%,8/47)、表面溃疡13处(27.66%,13/47),自发性出血21处(44.68%,21/47)。30处病灶行NBI放大内镜检查,病灶边界线清晰占86.67%(26/30),病灶黏膜下微血管不规则或消失占96.67%(29/30),病灶上皮微细结构和腺管开口不规则或消失占90.00%(27/30)。病理分型以分化型为主(89.36%,42/47)。结论 EGC多见于胃窦部,形态以0-Ⅱc型为主,在白光内镜下注意观察胃黏膜局部色调的改变及特征,以及NBI放大内镜下病灶边界、黏膜下微血管及上皮微细结构和腺管开口的变化,有助于提高EGC的诊断率。 Objective To investigate and analyze the detection of early gastric cancer(ECG)and explore the endoscopic and pathological characteristics.Methods Clinical data of patients underwent gastroscopy in2016were retrospectively collected for the screening and statistics of the detection rate of ECG(detected in examination and confirmed by pathology).In addition,the clinical data of43detected patients with ECG(47lesions)were retrospectively summarized.Endoscopic characteristics under a white light endoscope and a magnifying endoscope with narrow band imaging(NBI)as well as pathological characteristics of ECG were compared.Results The overall detection rate of ECG was0.23%(43/18,534),accounting for24.71%(43/174)in the total detected cases of gastric cancer.This study revealed that ECG was the most commonly detected in the gastric antrum(36.17%,17/47),lesion size>1.0cm was the most common(68.09%,32/47),and0-IIc type were the most common under the endoscope,accounting for55.32%(26/47).Under the white light endoscope,35(74.47%,35/47)lesions showed mucosal redness,43(91.49%,43/47)lesions presented clear boundaries,42(89.36%,42/47)lesions exhibited irregular surface,39(82.98%,39/47)lesions demonstrated mucosal atrophy and(or)intestinal metaplasia,17(36.17%,17/47)lesions presented edge burrs,8(17.02%,8/47)lesions showed WOS,13(27.66%,13/47)lesions had superficial ulcers,and21(44.68%,21/47)lesions demonstrated spontaneous bleeding.Magnifying endoscopy with NBI was conducted in30lesions,revealing clear boundaries in86.67%(26/30)lesions,irregular or disappeared submucosal microvasculature in96.67%(29/30)lesions,and irregular or disappeared epithelial microstructure and pit pattern in90.00%(27/30)lesions.Differentiated pathological type was dominant(89.36%,42/47).Conclusion ECG mainly occurs in the gastric antrum and0-IIc type are dominant.Careful observation of the changes and characteristics of the local tone of gastric mucosa under a white light endoscope as well as the changes in lesion boundaries,submucosal microvasculature,epithelial microstructure and pit pattern under a magnifying endoscope with NBI is helpful to improve the diagnosis rate of ECG.
作者 蔡升 周建波 桑建忠 宋奇峰 杨倩倩 黄戬 周琴 Sheng Cai;Jian-bo Zhou;Jian-zhong Sang;Qi-feng Song;Qian-qian Yang;Jian Huang;Qin Zhou(Department of Gastroeuterology, Yangming Hospital affiliated to Ningbo University (Yuyao People's Hospital), Yuyao, Zhejiang 315400, China)
出处 《中国内镜杂志》 2018年第3期94-99,共6页 China Journal of Endoscopy
基金 余姚市科技计划(No:2016YPT04) 宁波市医学科技计划(No:2016A51)
关键词 浙江省余姚地区 胃镜检查 早期胃癌 病理 形态学 Yuyao of Zhejiang province gastroscopy early gastric cancer pathology morphology
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  • 1王沧海,于永征,于中麟.放大内镜对胃黏膜肠上皮化生及萎缩的观察研究[J].中华消化内镜杂志,2005,22(3):164-166. 被引量:20
  • 2白杨,张亚历,张振书.共聚焦激光内镜的临床应用[J].中华消化内镜杂志,2006,23(4):316-317. 被引量:3
  • 3吴云林.早期胃癌研究必须从学科群建设抓起[J].内科理论与实践,2006,1(1):61-62. 被引量:38
  • 4吴云林,吴巍,郭滟,蔚青,江凤翔,胡伟国,燕敏,朱正纲.胃黏膜高级别上皮内瘤变的内镜识别与手术病理的结果[J].上海交通大学学报(医学版),2007,27(5):552-554. 被引量:43
  • 5Endo J, Awakawa T, Takahashi H, et al. Classification of Barrett epithelium by magnifying endoscopy. Gaslrointest Endoseo, 2002,55:645 -647.
  • 6Kwee RM, Kwee TC. The accuracy of endoscopic ultrasonography in differentiating mucosal from deeper gastric canecr. Am J Gastroenterol,2008,103 : i 801-1809.
  • 7Mouri R,Yoshida S,Tanaka S, et al. Usefulness of cndoseopie ultrasonography in determining the depth of invasion and indication for endoscopic treatment of early gastric cancer. J Clin Gastroenterol 2009,43 : 318-322.
  • 8Machida H, Sano Y, Hamamoto Y, et al. Narrow-band imaging in the diagnosis of colorectal mucosal lesions: a pilot study. Endoscopy.2004,36 : 1094-1098.
  • 9Mutu M, Katada C, Sanu Y, Yushida S. Narrow band imaging: a new diagnostic approach to visualize angiogenesis in superficial neoplasia. Clin Gastroenterol Hepatol,2005,3 (7 Suppl 1 ) :S16-20.
  • 10Participants in the Paris Workshop. The Pads endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon.Gastrointest Endosc, 2003, 58 ( Suppl 6) : s3-43.

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