胃镜活组织检查和内镜下切除病理检查对胃上皮内瘤变的准确性比较

Pathological diagnosis accuracy of gastric intraepithelial neoplasia by gastroscopic biopsy and endoscopic excision

目的分析胃上皮内瘤变予以内镜下切除病理诊断和胃镜活组织检查的准确性。方法选择2016年7月至2017年4月就诊的胃上皮内瘤变患者90例,均经胃镜病理活检检查确诊,均予以内镜下切除,比较内镜下切除和胃镜活组织检查的结果准确性,评估内镜下切除病理检查和胃镜活组织检查的差异影响因素。结果内镜下切除病理诊断为低级别上皮内瘤变14例,高级别上皮内瘤变30例,早期胃癌46例;胃镜活组织检查低级别上皮内瘤变8例,高级别上皮内瘤变22例,早期胃癌31例,两种病理检查结果差异有统计学意义(P<0.05);经Cox回归分析显示,胃镜活组织检查和内镜下切除病理诊断的差异影响因素为病灶直径、黏膜充血(P<0.05)。病灶直径、黏膜充血是胃镜活组织检查和内镜下切除病理诊断的差异影响因素,差异有统计学意义(P<0.05)。结论胃上皮内瘤变患者予以内镜切除标本病理检查结果,可切除病变,明确病理组织学诊断,比内镜活组织检查的准确性更高,实用价值更高。

Objective To investigate the pathological diagnosis accuracy of gastric intraepithelial neoplasia by endoscopic excision and gastroscopic biopsy.Methods A total of 90 patients with gastric intraepithelial neoplasia who were treated in our hospital from July 2016 to April 2017 in our hospital were enrolled in the study,who were diagnosed by gastroscopic pathological biopsy and undrwent endoscopic excision.The accuracy of results was compared between endoscopic excision and gastroscopic biopsy.Moreover the different influence factors of endoscopic excision pathological examination and gastroscopic biopsy were evaluated.Results According to the pathological examination of endoscopic excision,there were 14 cases of low grade intraepithelial neoplasia,30 cases of high grade intraepithelial neoplasia and 46 cases of early gastric cancer.Based on the gastroscopic biopsy,there were 8 cases low grade intraepithelial neoplasia,22 cases of high grade intraepithelial neoplasia and 31 cases of early gastric cancer.There were statistically significant difference between the two pathological examination results(P<0.05);moreover the difference influence factors of pathological diagnosis by gastroscopic biopsy and endoscopic excision were diameter of the nidus and mucosal hyperemia,and there were statistically significant differences(P<0.05).Conclusion According to the results of pathological examination of endoscopic resection specimens,the pathological changes can be resected in patients with gastric intraepithelial neoplasia,and the diagnosis of pathologic histology can be definited,and the diagnosis accuracy is higher than that by endoscopic biopsy examination.