肠镜活检高级别上皮内瘤变的临床病理诊断意义

Significance of Colonoscopy Biopsy for the Clinicopathologic Diagnosis of High-grade Intraepithelial Neoplasia

分析肠镜活检高级别上皮内瘤变的临床病理诊断意义。选取2019年2月—2023年2月于贵州省六盘水市第二人民医院进行肠镜活检诊断为结直肠高级别上皮内瘤变的63例患者为研究对象,统计分析63例患者的术后常规病理结果和术前肠镜活检结果,采用单因素分析与多因素Logistic回归分析术前肠镜活检结直肠高级别上皮内瘤变最终癌变的危险因素。结果表明,术后常规病理确诊腺癌检出率为71.43%,与术前肠镜相比(P<0.05)。腺癌患者的肿瘤大小≥3 cm的比例与大便潜血阳性率这两个指标差异有统计学意义(P<0.05),其他各指标无统计学差异(P>0.05)。多因素Logistic回归分析显示,仅肿瘤大小≥3 cm最为显著(P<0.05)。研究发现,高级别上皮内瘤变肠镜活检的临床病理诊断意义显著,肿瘤大小≥3 cm的癌变预测价值高,应该积极处理。

To analyze the clinicopathological diagnostic significance of colonoscopic biopsy of high-grade intraepithelial neoplasia.A total of 63 patients diagnosed with colorectal high-grade intraepithelial neoplasia by colonoscopy biopsy in the Second People’s Hospital of Liupanshui City,Guizhou Province from February 2019 to February 2023 were selected as the research subjects,and the postoperative routine pathological results and preoperative colonoscopy biopsy results of 63 patients were statistically analyzed,and the risk factors for colorectal high-grade intraepithelial neoplasia and final carcinogenesis were analyzed by univariate analysis and multivariate logistic regression analysis.The results showed that the detection rate of adenocarcinoma was 71.43%after routine pathology,which was compared with that of preoperative colonoscopy(P<0.05).There was a significant difference between the proportion of tumor size≥3 cm and the positive rate of fecal occult blood in adenocarcinoma patients(P<0.05),but there was no significant difference in other indexes(P>0.05).Multivariate Logistic regression analysis showed that only tumor size≥3 cm was the most significant(P<0.05).The study found that colonoscopic biopsy of high-grade intraepithelial neoplasia was of significant significance in the diagnosis of clinical pathology,and the tumor size of≥3 cm had a high predictive value for cancer,which should be actively treated.