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本文总结分析经内窥镜下活检及手术病理检查确诊的1,401例上消化道疾病的印检、刷检活检及联合使用的结果。结果表明:308例胃癌的印检加活检(99.26％)、刷检加活检(97.97％)、及印检加刷检加活检(97.97％)的阳性率显著高于单独活检(84.42％)(p<0.01)。22例早期胃癌和41例食管癌,印检加刷检加活检的阳性率(90.91％,100％),也分别显著高于其单独活检(63.64％、90.24％)(p<0.05)。在常见的胃窦胃角癌、胃体癌及溃疡型癌也有同样结果。认为:印检、刷检与活检联合使用,不仅能显著提高食管癌和进展期胃癌的阳性率,而且对早期胃癌检出率的提高也有一定价值。鉴于印检、刷检还具有简便、安全、经济、不显著延长检查时间等优点,因此,可将印检、刷检与活检一起,列为日常上消化道纤维内窥镜的常规检查内容,也可推广到上消化道恶性肿瘤普查中去,在“二级预防”中起一定作用。同期确诊的1,052例非癌疾病,印检、刷检的假阳性率分别是1.24％和3.35％,认为进一步提高对上皮不典型增生(dysplasia)的认识,是减少和避免假阳性的关键。
This article summarizes and analyzes the results of biopsy, brush biopsy, and combined use of 1,401 upper digestive diseases diagnosed by endoscopic biopsy and surgical pathology. The results showed that the positive rates of biopsy plus biopsy (99.26%), brushing plus biopsy (97.97%), and biopsy plus biopsy (97.97%) were significantly higher in 308 cases of gastric cancer than in biopsy alone (84.42%). p<0.01). In 22 cases of early gastric cancer and 41 cases of esophageal cancer, the positive rates of biopsy plus biopsy (90.91%, 100%) were also significantly higher than those of biopsy alone (63.64%, 90.24%) (p<0.05). The same results are found in common gastric antrum cancers, gastric body cancers, and ulcerated cancers. It is believed that the combined use of India, brush and biopsy can not only significantly increase the positive rate of esophageal cancer and advanced gastric cancer, but also have a certain value for the improvement of the detection rate of early gastric cancer. In view of the advantages of simple, safe, economical, and not significantly prolonged inspection time, the inspection and brushing inspections can be combined with the inspection, brushing inspection, and biopsy as routine inspections of daily upper gastrointestinal fiber endoscopes. Can also be extended to the general gastrointestinal cancer screening, in the “secondary prevention” play a role. The false positive rates of 1,052 non-cancer diseases diagnosed during the same period in India and Japan were 1.24% and 3.35%, respectively. It is believed that the further improvement of epithelial dysplasia is the key to reducing and avoiding false positives.