胃癌术前胃镜活检病理与外科术后病理的临床分析

Clinical analysis of preoperative gastroscopy biopsy and postoperative pathology of gastric cancer

目的:对比分析胃癌术前胃镜活检病理与外科术后病理的诊断价值。方法:选取2015年5月-2019年5月行手术治疗的胃癌患者20例,所有患者均给予术前胃镜活检病理与外科术后病理检查;对比分析两种检测方式的诊断作用。结果:术后病理检验的确诊率明显高于术前胃镜活检,差异有统计学意义(P<0.05)。术后病理检验对黏液腺癌及管状腺癌的诊断率明显高于术前胃镜活检,差异有统计学意义(P<0.05);而术前胃镜活检对乳头状腺癌及低黏附性癌的诊断率则明显高于术后病理检验,差异有统计学意义(P<0.05)。术后病理检验对病理分化的诊断率明显高于术前胃镜活检,差异有统计学意义(P<0.05)。以术后病理检验结果为金标准,术前胃镜活检的敏感度为93.0%、准确性为87.0%、阳性预测值为93.0%。结论:术前胃镜活检与术后病理检验在胃癌的临床诊断中存在较大差异,但胃镜活检操作相对简便,且敏感度、准确性以及阳性预测值均较高,可应用到早期筛查及疗效预判中。

Objective:To compare and analyze the diagnostic value of preoperative gastroscopy biopsy pathology and postoperative pathology of gastric cancer.Methods:From May 2015 to May 2019,20 cases of patients with gastric cancer who underwent surgery were selected,all patients were given preoperative gastroscopy biopsy pathology and postoperative pathology.The diagnostic effect of the two methods was compared and analyzed.Results:The diagnosis rate of the postoperative pathology was significantly higher than the preoperative endoscopic biopsy,the difference was statistically significant(P<0.05).The diagnosis rate of mucinous adenocarcinoma and tubular adenocarcinoma by postoperative pathology was higher than that of preoperative gastroscopy,the difference was statistically significant(P<0.05).The diagnosis rate of mucinous adenocarcinoma and tubular adenocarcinoma by preoperative gastroscopy was higher than that of postoperative pathology,the difference was statistically significant(P<0.05).The diagnosis rate of pathological differentiation by postoperative pathology was higher than that of preoperative gastroscopy,the difference was statistically significant(P<0.05).Took the postoperative pathological results as the gold standard,the sensitivity,accuracy and positive predictive value of preoperative gastroscopy biopsy were 93.0%,87.0% and 93.0% respectively.Conclusion:There are significant differences between preoperative gastroscopy biopsy and postoperative pathological examination in the clinical diagnosis of gastric cancer,however,the gastroscopy biopsy is relatively simple,and the sensitivity,accuracy and positive prediction values are all high,which can be applied to the early screening and efficacy prediction.