早期胃癌内镜下病灶范围估测与手术病理的比较

Difference of tumor size between endoscopic estimation and postoperative pathological measurement in early gastric carcinoma

目的:早期胃癌病灶范围的内镜下活检钳估测与术后病理测量结果差异的研究.方法:对118例早期胃癌患者的病灶范围进行胃镜下及术后病理测量,对临床病理特征与测量误差的关系进行相关分析.结果:早期胃癌病灶内镜下活检钳测量与手术后病理测量相符的26例(22.0%),有误差的92例(77.9%),其中活检钳测量小于手术后病理测量的72例(占61.0%).大体形态分型中,凹陷型比隆起型、平坦型测量误差率高.组织类型中,低分化型比分化型胃癌测量误差率高.结论:凹陷型和低分化型早期胃癌,内镜下活检钳法测量病灶范围与术后病理测量相比常有较大的误差,一般小于病理测量,除内镜操作者的经验外,与癌灶的生物学特性或许有一定关联.

AIM:To study the difference of tumor size between endoscopic estimation and postoperative patholoigical measurement in early stage of gastric carcinoma. METHODS:The size of lesion was estimated by biopsy forceps at endoscopy and by postoperative pathological measurement in 118 patients with early gastric cancer. The correlation be- tween clinicopathological features and measuring errors were analyzed. RESULTS:Through two different ways of measurement, there was coincidence in 26 of 118 cases (22.0 %), and unconformity in 92 of 118 cases (77.9 %). The size esti- mated by biopsy forceps at endoscopy was smaller than by postoperative pathological measurement.In histological study, the measuring error rate was higher in the lowly- differentiated type than that in the highly-differentiated type. CONCLUSION:There were significant measuring errors in tumor size between endoscopic estimation and pathologi- cal measurement in depressed and lowly-differentiated type.The tumor size was smaller in endoscopic estimation than that in the postoperative pathological measurement. This measuring error may be associated with the biological fea- ture of gastric cancer, except the experiences of endoscopists.