胃黏膜活检标本规范化处理对病理诊断病变检出率的影响

Effect of standardized treatment of gastric mucosal biopsy specimens on detection rate of lesions in pathological diagnosis

目的 分析胃黏膜活检标本规范化处理对病理诊断病变检出率的影响。方法 200例接受胃镜检查并取活检的患者,对内镜下判断胃黏膜疑似存在神经内分泌瘤、淋巴瘤、癌、高级别上皮内瘤变、低级别上皮内瘤变、肠化、萎缩及炎症的病变进行活检,每例患者病变部位选取两份标本,其中一份标本给予常规活检标本处理,并将处理结果作为对照组(200份);另一份标本给予规范化的活检标本处理,并将处理结果作为观察组(200份)。对比两组测定标本的大小,形态及病理诊断结果差异。结果 测定后,观察组诊断标本大小(4.89±0.3)mm显著大于对照组的(2.48±0.25)mm,差异有统计学意义(P<0.05);观察组标本形态平坦状占比95.50%显著高于对照组的2.00%,弧形状占比2.00%、团块状占比2.50%显著低于对照组的32.50%、65.50%,差异有统计学意义(P<0.05)。测定后,两组病理结果中神经内分泌瘤、淋巴瘤、癌、高级别上皮内瘤变检出率对比,差异无统计学意义(P>0.05);观察组病理诊断结果中低级别上皮内瘤变、肠化、萎缩、炎症检出率分别为8.00%、32.50%、44.00%、57.00%,显著高于对照组的3.00%、19.00%、25.00%、32.50%,差异有统计学意义(P<0.05)。结论 胃黏膜活检标本规范化处理能够使标本的形态更为规范化,有助于对病理的诊断鉴别,临床应用价值显著。

Objective To analyze the effect of standardized treatment of gastric mucosal biopsy specimens on detection rate of lesions in pathological diagnosis.Methods In 200 patients who underwent gastroscopy,biopsies were performed on gastric mucosal lesions suspected of neuroendocrine tumor,lymphoma,carcinoma,high-grade intraepithelial neoplasia,low-grade intraepithelial neoplasia,intestinal metaplasia,atrophy and inflammation.Two specimens were selected from each lesion site.One specimen was given routine biopsy specimen treatment and the treatment results were taken as the control group(200 specimens),and the other specimen was given standardized biopsy specimen treatment and the treatment results were taken as the observation group(200 specimens).The size,morphology and pathological diagnosis of the two groups were compared.Results After determination,the size of diagnostic specimen in the observation group was(4.89±0.3)mm,which was significantly larger than that of(2.48±0.25)mm in the control group,and the difference was statistically significant(P<0.05).The proportion of flat specimens of 95.50%in the observation group was significantly higher than that of 2.00%in the control group;the proportion of arc-shaped and clumpy specimens were 2.00%and 2.50%in the observation group,which were significantly lower than those of 32.50%and 65.50%in the control group;the differences were statistically significant(P<0.05).After determination,there was no statistically significant difference in the detection rates of neuroendocrine tumor,lymphoma,carcinoma and high-grade intraepithelial neoplasia between the two groups(P>0.05).The detection rates of low-grade intraepithelial neoplasia,intestinal metaplasia,atrophy and inflammation in the observation group were 8.00%,32.50%,44.00%and 57.00%,which were significantly higher than those of 3.00%,19.00%,25.00%and 32.50%in the control group,and the differences were statistically significant(P<0.05).Conclusion The standardized treatment of gastric mucosal biopsy specimens can make the morphology of specimens more standardized,which is helpful to the diagnosis and differentiation of pathology,and has significant clinical value.