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目的:分析结直肠内窥镜活检癌的病理特征,为临床诊断提供依据。方法:选取2012年6月~2014年2月在我院接受结肠、直肠检查的321例患者作为研究对象,均给予结直肠内窥镜活检诊断,与切除手术病理诊断对照,分析其病理特征。结果:299例患者为腺癌,4例患者为印戒细胞癌,2例患者为类癌,16例患者为粘液腺癌,患者组织学特征主要表现有一定的差异,粘液腺癌患者主要表现为出现大量粘液,腺癌特征是腺管状腺泡状分化,阳性标记CK、CEA、Ki-67等,类癌特征为癌细胞大小、染色比较均匀,常见腺泡状,印戒细胞癌细胞核深染,活检诊断与术后诊断符合率为100%。结论:由于结直肠癌病例大多数为浸润癌,因此结直肠活检中,不能确定黏膜下层的患者,不应使用黏膜内肿瘤进行诊断。同时内窥镜、外科医师应多取材、深取材,与病理医生多沟通,必要时配合影像学检查,以提高临床诊断准确性[1]。
Objective: To analyze the pathological features of colorectal endoscopic biopsy and provide basis for clinical diagnosis. Methods: A total of 321 patients undergoing colon and rectum examinations in our hospital from June 2012 to February 2014 were selected for biopsy of colorectal endoscopy. The pathological features were compared with the pathological diagnosis of resection. Results: 299 cases of adenocarcinoma, 4 cases of signet ring cell carcinoma, 2 cases of carcinoid, 16 cases of mucinous adenocarcinoma, the histological features of patients showed some differences, the main manifestations of mucinous adenocarcinoma In order to appear a large number of mucus, adenocarcinoma is characterized by glandular tubular acinar differentiation, positive markers CK, CEA, Ki-67, carcinoid cells characterized by the size of the cancer, more evenly stained, common alveolar, signet ring cell carcinoma cell nucleus deep Dye, biopsy diagnosis and postoperative diagnosis consistent rate was 100%. CONCLUSIONS: Because colorectal cancer is mostly invasive, colorectal biopsies can not identify submucosal patients and should not be diagnosed using intramucosal tumors. At the same time endoscopes, surgeons should be more material, deep drawing, more communication with the pathologist, if necessary, with imaging examination to improve the accuracy of clinical diagnosis [1].