摘要
目的探讨胃镜组织活检与外科手术标本病理诊断胃癌结果的差异。方法回顾性分析该院2008年1月—2018年6月该院首诊的121例胃癌患者的临床资料,以外科手术标本病理诊断结果为金标准,比较胃镜组织活检与手术标本病理检查的一致性。结果胃镜组织活检诊断胃癌符合率为81%(98/121),疑诊率15.7%(19/121),未确诊率3.3%(4/121);两种方法对组织学类型诊断一致率为85.1%(103/121),kappa值为0.779,差异有统计学意义(χ~2=207.567,P<0.05);两种方法对胃癌分化程度诊断一致率为87.6%(106/121),kappa值为0.718,差异有统计学意义(χ~2=62.629,P<0.05)。结论胃镜组织活检对胃癌诊断的符合率、组织学类型和分化程度判断的较高的一致性,但由于取材标本量少,不能全面客观地反映胃癌病变的严重程度,特别是对管状腺癌和未分化癌细胞的判断存在较大的误差,因而胃镜只能作为术前筛选的方法,最终确诊应以手术标本病理结果为准。
Objective To investigate the differences in the results of gastroscopy biopsy and surgical specimens for patho- logical diagnosis of gastric cancer. Methods The clinical data of 121 patients with gastric cancer who were first diagnosed in the hospital from January 2008 to June 2018 in the hospital were retrospectively analyzed. The pathological diagnosis re- suits of surgical specimens were used as the gold standard. The biopsy of gastroscopy and pathological examination of surgi- cal specimens were compared. Results The coincidence rate of gastroscopy biopsy for diagnosis of gastric cancer was 81% （98/121）, the suspected rate was 15.7% （19/121）, and the undiagnosed rate was 3.3% （4/121）. The consistency of the two meth- ods for histological type diagnosis correlation was 85.1% （103/121） and the kappa value was 0.779. The difference was sta- tistically significant （X2=207.567, P〈0.05）. The diagnostic rate of the two methods for the differentiation of gastric cancer was 87.6% （106/121）, kappa value was 0.718, the difference was statistically significant （X2=62.629, P〈0.05）. Conclusion Gastric biopsy has a high consistency in the coincidence rate, histological type and differentiation degree of gastric cancer diagnosis. However, due to the small amount of specimens, it can not fully and objectively reflect the severity of gastric caneer lesions, especially for tubular adenocarcinoma. There is a large error in the judgment of undifferentiated cancer cells. Therefore, gastroscopy can only be used as a method for preoperative screening. The final diagnosis should be based on the pathological results of surgical specimens.
作者
孙永辉
邢瑜
SUN Yong-hui;XING Yu(Department of Radiology,Third People＇s Hospital of Laiyang City,Laiyang,Shandong Province,265219 China;Department of Pharmacy,Third People＇s Hospital of Laiyang City,Laiyang,Shandong Province,265219 China)
出处
《中外医疗》
2018年第31期188-190,共3页
China & Foreign Medical Treatment
关键词
胃癌
胃镜组织活检
外科手术病理
Gastric cancer
Endoscopic biopsy
Surgical pathology
