胃肠道高级别上皮内瘤变术后病理分析
Postoperative pathological analysis of high-grade intraepithelial on gastrointestinal tract
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摘要: 目的:探讨胃肠道活组织检查病理诊断高级别上皮内瘤变(high-grade intraepithelial neoplasia,HIN)的价值。方法:对经内镜活检病理诊断为HIN的52例患者的临床和病理资料进行回顾性分析,并与术后病理诊断结果进行对比。结果:内镜下病灶3 cm的HIN患者27例,其中上消化道18例,术后诊断为癌13例;结直肠9例,术后诊断为癌1例,差异有统计学意义(P=0.004)。内镜下病灶3 cm与3 cm的上消化道肿瘤中诊断为癌者差异无统计学意义(P=1.000);而内镜下病灶3 cm和3 cm的结直肠肿瘤患者中诊断为癌者差异有统计学意义(P=0.002)。结论:术前内镜活检病理为HIN的上消化道病灶,建议积极地治疗。范围3 cm结直肠病灶,手术治疗则需要十分慎重。Abstract: Objective:To investigate the pathological diagnostic value of gastrointestinal biopsy on high-grade intraepithelial neoplasia(HIN).Methods:A retrospective analysis of clinical and pathological information was done in 52 cases who were diagnosed as HIN by endoscopic biopsy,and the pathological diagnostic results were compared.Results:In total HIN patients,27 cases were diagnosed as the scope of endoscopic lesion was 3 cm,including 18 cases whose lesion was in upper digestive tract,and 13 cases were diagnosed as cancer with postoperative pathological analysis;9 cases whose lesion was in colon and rectum,1 case was diagnosed as cancer.There was statistical difference in the two groups(P=0.004).The ratio of cancer in upper gastrointestinal tract in these two groups whose lesion range was 3 cm or 3 cm were compared,there was no difference in two groups which diagnosed cancer in upper gastroinfestfinal tract regardless of lesion ragne(P=1.000);but there was statistical difference in colorectal patients whose lesion range was 3 cm or 3 cm(P=0.002).Conclusions:It needs to choose an active treatment when preoperative endoscopic biopsy is diagnosed as HIN in upper digestive tract.The surgical operation needs to be prudent when lesion range is 3 cm in colorectal lesion.