發(fā)布時(shí)間：2018-04-18 08:38

  本文選題：內(nèi)鏡黏膜下剝離術(shù) + 病理��； 參考：《蘇州大學(xué)》2015年碩士論文

【摘要】：目的:比較分析內(nèi)鏡黏膜下剝離術(shù)前后病理變化影響因素,初步探討內(nèi)鏡黏膜下剝離術(shù)在食管早癌及癌前病變中的診斷價(jià)值。方法:在研究期間,共發(fā)現(xiàn)白光內(nèi)鏡下活檢提示食管高級(jí)別上皮內(nèi)瘤變的病灶67例。所有患者均接受內(nèi)鏡黏膜下剝離術(shù),并在顯微鏡下觀察所切除標(biāo)本。根據(jù)術(shù)前和術(shù)后病理結(jié)果分為一致組和非一致組,以及術(shù)后病理較之活檢結(jié)果相同組和升高組。比較分析年齡、性別、病灶位置、長(zhǎng)度、標(biāo)本大小、大體分型、飲酒史等可能預(yù)測(cè)ESD術(shù)后病理因素。結(jié)果:活檢病理診斷與術(shù)后病理診斷相比,44.78%(30/67)診斷相符,46.27%(31/67)診斷不足,8.96%(6/67)的病灶診斷過度。術(shù)前術(shù)后病理一致組及ESD術(shù)后病理升高組相比,性別、病灶位置、標(biāo)本大小及大體分型等有統(tǒng)計(jì)學(xué)差異。結(jié)論:男性和/或病灶較寬和/或非食管中段病灶和/或淺表凹陷型病變其活檢結(jié)果可能診斷不足。內(nèi)鏡黏膜剝離術(shù)有診斷價(jià)值,能相對(duì)客觀地評(píng)價(jià)病理性質(zhì),并為進(jìn)一步治療提供依據(jù)。
[Abstract]:Objective: to compare and analyze the influencing factors of pathological changes before and after endoscopic submucosal dissection, and to explore the diagnostic value of endoscopic submucosal dissection in early esophageal carcinoma and precancerous lesions.Methods: during the study, 67 cases of high grade intraepithelial neoplasia of esophagus were detected by white light endoscopy biopsy.All patients underwent endoscopic submucosal dissection and the specimens were observed under microscope.According to the preoperative and postoperative pathological results, the patients were divided into consistent group and non-consistent group, as well as the same group and elevated group compared with biopsy results.Age, sex, location, length, size, gross classification and history of alcohol consumption may predict pathological factors after ESD.Results: compared with the postoperative pathological diagnosis, the pathological diagnosis of biopsy was consistent with the diagnosis of 44.78% 30 / 67 (46.27% / 67).There were significant differences in sex, location of lesion, size of specimen and gross type between the same group of preoperative and postoperative pathology and the group of histopathologic elevation after ESD.Conclusion: the biopsy results of male and / or lesion with wider and / or non-esophageal lesions and / or superficial concave lesions may be under-diagnosed.Endoscopic mucosal dissection has diagnostic value and can objectively evaluate pathological properties and provide basis for further treatment.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R735.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 陳濤;王靈芝;王莉芝;李建華;;胃鏡活檢對(duì)癌前病變的診斷價(jià)值[J];河北醫(yī)藥;2013年05期

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本文編號(hào)：1767602