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目的总结食管高级别上皮内瘤变诊断及治疗方法。方法回顾性分析28例食管高别上皮内瘤变患者的临床资料。结果接受内镜粘膜下剥离术手术治疗的28例患者中,16例(57%)术后病理证实维持高级别上皮内瘤变的诊断,其余12例(43%)术后则诊断为食管癌。结论内镜下病理检查诊断食管高级别上皮内瘤变准确率57%,内镜下活检不能作为高级别上皮内瘤变的确诊依据,应积极随访甚至手术干预。内镜粘膜下剥离术为治疗食管高级别上皮内瘤变的有效方法。
Objective To summarize the diagnosis and treatment of esophageal high grade intraepithelial neoplasia. Methods The clinical data of 28 patients with esophageal high-grade intraepithelial neoplasia were retrospectively analyzed. Results Of the 28 patients who underwent endoscopic submucosal dissection, 16 (57%) had pathologically confirmed high grade intraepithelial neoplasia and the remaining 12 (43%) had esophageal cancer after surgery . Conclusion The accuracy of endoscopic diagnosis of esophageal high-grade intraepithelial neoplasia is 57%. Endoscopic biopsy can not be used as the basis for the diagnosis of high-grade intraepithelial neoplasia, and should be actively followed up or even surgically treated. Endoscopic submucosal dissection for the treatment of esophageal high-grade intraepithelial neoplasia an effective method.