肠镜活检组织病理诊断对结直肠癌的诊断效果

大肠癌已成为全球范围内的重大健康问题,是最常见的三种癌症之一,排名第二。分析肠镜活检组织病理诊断对结直肠癌的诊断效果。方法 选取2022年1月-2023年8月40例结肠癌患者,随机分对照组(常规体检)与观察组(肠镜活检组织病理),对比诊断效果。结果 观察组比对照组诊断后检出率、特异度、敏感度、诊断准确率都高(P<0.05)。结论 对结直肠癌患者选择肠镜活检组织病理诊断效果明显,可推行使用。

肠镜活检组织检查结直肠癌患者的临床效果

目的 探讨肠镜活检组织检查结直肠癌患者的临床效果。方法 选取2017年3月至2019年3月医院收治的80例经肠镜活检组织检查确诊的结直肠癌患者作为研究对象,所有患者均进行肠镜活检组织检查,分析病灶组织的病理分型、病灶部位及浸润深度等情况。结果 80例结直肠癌患者病理检查结果中,腺癌67例(83.8%),占比最高,其中中分化腺癌60例,低分化腺癌4例,黏液腺癌3例,未分化癌3例(3.8%),印戒细胞癌5例(6.3%),其他类型癌5例(6.3%);80例结直肠癌患者中,直肠部位发病48例(60.0%),占比最高,左半肠24例(30.0%),右半肠6例(7.5%),回肠末端2例(2.5%);80例结直肠癌患者中,经病理检查确诊27例(33.8%)病灶组织浸润至正常黏膜,37例(46.3%)浸润至黏膜下层,16例(20.0%)浸润程度不确定。结论 肠镜活检组织检查可鉴别结直肠癌病灶的组织分型及浸润程度,为临床早期诊疗提供较为客观的依据。

采用放射性配体结合测定法检测幼儿组织谷氨酰胺转移酶自身抗体

目的:前瞻性筛查腹腔疾病(CD)易感性幼儿,测定其体内抗组织谷氨酰胺转移酶(tTG)自身抗体水平。方法:共有652名幼儿被纳入试验,其平均年龄为2.9岁(2.5-4.2岁),采用放射性配体结合测定法,检测抗组织谷氨酰胺转移酶免疫球蛋白A(IgA-tTG)和G (IgA-tTG);采用间接荧光免疫测定法,检测肌内膜抗体免疫球蛋白A(EMA)。对于自身抗体阳性儿童,平均1.2年(0.2-1.9年)后再次进行检测。对于自身抗体水平持续偏高的儿童,进行肠组织活检。结果:试验基准, 全部625名受试儿童中,3.2%(95%CI 1.9%-4.6%) 至少有1种自身抗体呈阳性:2.5%(95%CI 1.3%- 3.7%)出现IgA-tTG,1.7%(95%C1 0.7%-2.7%)

用于诊断儿童原发性乳糖酶缺乏症的基因检测方法

Background/Aims: Adult-type hypolactasia (primary lactose malabsorption) affects most of world’s human population and limits the use of fresh milk due to lactose intolerance. The diagnosis of adult-type hypolactasia has been difficult to establish because of unsatisfactory diagnostic methods. C/T 13910 single nucleotide polymorphism residing 13910 base pairs from the 5′end of the lactase gene has been shown to be associated with lactase persistence. The aim of the study was to assess the applicability of the C/T-13910 variant as a diagnostic test for adult-type hypolactasia during childhood. Methods: Intestinal biopsies were obtained from 329 children and adolescents of African, Finnish, and other White origins aged 0.1-20 years undergoing upper gastrointestinal endoscopy because of abdominal complaints. The biopsies were assayed for lactase, sucrase, and maltase activity and genotyped for the C/T-13910 variant using polymerase chain reaction minisequencing. Results: The frequency of the C/C-13910 genotype defining lactase non-persistence was well in agreement in this study with published figures for the prevalences of adult-type hypolactasia in Africans and Whites. The C/C-13910 genotype was associated with very low lactase activity (<10 U/g protein) in the majority of children tested at 8 years of age and in every child older than 12 years of age giving a specificity of 100% and sensitivity of 93% for the genetic test. The decline of lactase activity was somewhat earlier in African compared with Finnish children with C/C -13910 genotype (p < 0.03). Conclu sions: Genetic test of C/T -13910 polymorphism can be used as a first stage scr eening test for adult-type hypolactasia.

多中心调查:患腹部疾病的1型糖尿病儿童的身体测量指标、代谢控制和甲状腺自身免疫状况

To investigate the influence of celiac disease (CD) on growth and metabolic control in a nationwide cohort of children and adolescents with type 1 diabetes (T1D). We analyzed data from 19, 796 pediatric patients with T1D in the German pediatric multicenter DPV-database for occurrence of CD. CD-specific antibodies were present in 1326 patients (6. 7% ). The diagnosis was confirmed in 127 patients (0. 6% ) by small-bowel biopsy. Female subjects were significantly more predisposed to have T1D and CD. The CD-affected patients in our cohort were significantly younger at diabetes onset. Furthermore, they had significantly lower height-SDS at onset (-0. 49 vs-0. 06, P < .05), a difference that increased during the course of the disease (-0. 80 vs-0. 26 after 9 years of diabetes, P < . 05). In addition, body mass index-SDS significantly differed between the groups (0. 22 vs 0. 47, P < . 05). Evidence for thyroid disease was more commonly observed in the T1D with CD group (6. 3% vs 2. 3% , P < . 05). HbA1c values were lower in the patients with T1D and CD. The CD-positive patients were characterized by earlier onset of diabetes and decreased growth and weight gain. These findings emphasize the clinical relevance of celiac disease in patients with autoimmune diabetes.

Magnifying colonoscopy as a non-biopsy technique for differential diagnosis of non-neoplastic and neoplastic lesions

AIM： To clarify whether mucosal crypt patterns observed with magnifying colonoscopy are feasible to distinguish non-neoplastic polyps from neoplastic polyps. METHODS： From June 1999 through March 2000, 180 consecutive patients with 210 lesions diagnosed with a magnifying colonoscope （CF-200Z, Olympus Optical Co., Ltd., Tokyo, Japan） were enrolled. Magnification and chromoendoscopy with 0.2% indigo-carmine dye was applied to each lesion for mucosal crypt observation. Lesions showing types Ⅰ and Ⅱ crypt patterns were considered non-neoplastic and examined histologically by biopsy, whereas lesions showing types Ⅲ to Ⅴ crypt patterns were removed endoscopically or surgically. The correlation of endoscopic diagnosis and histologic diagnosis was then investigated. RESULTS： At endoscopy, 24 lesions showed a type Ⅰ or Ⅱ pit pattern, and 186 lesions showed type Ⅲ to Ⅴ pit patterns. With histologic examination, 26 lesions were diagnosed as non-neoplastic polyps, and 184 lesions were diagnosed as neoplastic polyps. The overall diagnostic accuracy was 99.1% （208/210）. The sensitivity and specificity were 92.3% （24/26） and 99.8% （184/186）, respectively. CONCLUSION： Magnifying colonoscopy could be used as a non-biopsy technique for differentiating neoplastic and non-neoplastic polyps.

Jumbo biopsy is useful for the diagnosis of colonic prolapsing mucosal polyps with diverticulosis

We report here a case of multiple prolapsing mucosal polyps with diverticulosis in the sigmoid colon. A 52-year- old man was admitted to our hospital because of bloody diarrhea. Colonoscopy and barium enema showed multiple diverticula, markedly thickened mucosal folds and polypoid lesions with mucus on the top of them in the sigmoid colon. Endoscopic ultrasonography showed thickening of the mucosal and submucosal layers. Several endoscopic biopsy specimens were taken from the polypoid lesions. Histological examination revealed only chronic inflammatory cell infiltration. In order to obtain a definite diagnosis, we performed endoscopic jumbo biopsy for the polypoid lesions after obtaining informed consent. Histological examination revealed marked lymphocyte infiltration, hemosiderin deposits and fibromuscular obliteration in the lamina propria, features similar to those of mucosal prolapsing syndrome. After anti-diarrhetic treatment, clinical findings were improved. Thus, jumbo biopsy is useful for diagnosis and treatment of prolapsing mucosal polyps.

Comparison of three PCR methods for detection of Helicobacter pylori DNA and detection of cagA gene in gastric biopsy specimens

AIM:To comparatively evaluate PCR and other diagnostic methods (the rapid urease test and/or culture) in order to determine which of the three PCR methods (ureA,glmM and 26-kDa,SSA gene) was most appropriate in the diagnosis of Helicobacterpylori(Hpylori) infection and also to evaluate the detection of a putative virulence marker of H pylori,the cage,gene,by PCR in biopsy specimens. METHODS:One hundred and eighty-nine biopsy specimens were collected from 63 patients (three biopsies each) undergoing upper gastroduodenal endoscopy for various dyspeptic symptoms.The PCR methods used to detect H pylori DNA directly from biopsies were the glmM,26-kDa, ureA and then cagA was used to compare the culture technique and CLO for urease with the culture technique being used as the gold standard. RESULTS:Thirty-five percent of the biopsies were positive for H pylori DNA using the 3 PCR methods,while 68% of these were positive for the cagA gene.Twenty-four percent of the biopsies were negative for H pylori DNA in all PCR methods screened.The remaining 41% were either positive for ureA gene only,glmM only,26-kDa only,or ureA+glmM, ureA+26-kDa,glmM+26-kDa.Out of the 35% positive biopsies,41% and 82% were positive by culture and CLO respectively,while all negative biopsies were also negative by culture and cagA.Cag A+ infection was also predominantly found in H pylori DNA of the biopsies irrespective of the clinical diagnosis. CONCLUSION:This method is useful for correctly identifying infections caused by H pylori and can be easily applied in our laboratory for diagnostic purposes.