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目的研究染色放大内镜下胃癌前病变黏膜小凹及微血管的变化与病理组织学的相关性,探讨放大内镜用于诊断癌前病变的可能性。方法应用O lympus G IF-Q240Z放大内镜对256例胃癌前病变黏膜进行观察,局部喷洒0.4%靛胭脂染色后利用其放大功能观察胃小凹形态及微血管改变并记录。在观察及记录区内取材送病理组织学检查。结果 256例患者中,肠上皮化生及异型增生黏膜胃小凹形态主要表现为E型(91.5%)和F型(87.1%)。根据胃黏膜小凹形态及微血管特征,色素放大内镜下对胃黏膜肠上皮化生及异型增生的镜下诊断符合率分别为87.5%及80.6%。结论胃小凹形态及其微血管改变有助于临床对胃黏膜病变性质的判断。
Objective To study the correlation between the changes of mucosa and microvessels in gastric precancerous lesions and pathological histology under magnifying endoscopy, and to explore the possibility of magnifying endoscopy for the diagnosis of precancerous lesions. Methods The mucosa of 256 gastric precancerous lesions were observed with O lympus G IF-Q240Z magnifying endoscope, and the morphological and microvascular changes of gastric pits were observed with 0.4% indigo carmine staining and recorded. Observe in the observation and recording area taken for histopathological examination. Results Among the 256 patients, the morphology of intestinal metaplasia and dysplasia of mucosa was mainly E (91.5%) and F (87.1%). According to the morphology of gastric mucosa and the characteristics of microvessels, the coincident rates of microscopic diagnosis of intestinal mucosa intestinal metaplasia and dysplasia by color enlarging endoscopy were 87.5% and 80.6% respectively. Conclusion The shape of gastric pits and its microvascular changes contribute to the clinical judgment of the nature of gastric mucosal lesions.