[1]郭晓红,杨根源,施　茜,等.富士智能染色内镜与放大内镜模式下标准活检钳冷切除结直肠微小腺瘤的组织学完全切除率评估[J].新乡医学院学报,2016,33(8):670-674.[doi:10.7683/xxyxyxb.2016.08.006]
　GUO Xiao-hong,YANG Gen-yuan,SHI Qian,et al.Evaluation of complete histological resection rate of diminutive colorectal adenomas by standard biopsy forceps combined with Fujinon intelligent chromoendoscopy and magnified endoscopy[J].Journal of Xinxiang Medical University,2016,33(8):670-674.[doi:10.7683/xxyxyxb.2016.08.006]
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富士智能染色内镜与放大内镜模式下标准活检钳冷切除结直肠微小腺瘤的组织学完全切除率评估
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
33
期数:
2016年8
页码:
670-674
栏目:
临床研究
出版日期:
2016-07-27

文章信息/Info

Title:
Evaluation of complete histological resection rate of diminutive colorectal adenomas by standard biopsy forceps combined with Fujinon intelligent chromoendoscopy and magnified endoscopy
作者:
郭晓红1; 杨根源2; 施　茜2; 院秀娟1; 李楚滨1
（1.珠海市人民医院病理科，广东　珠海　519000；2.珠海市人民医院内镜中心，广东　珠海　519000）
Author(s):
GUO Xiao-hong1; YANG Gen-yuan2; SHI Qian2; YUAN Xiu-juan1; LI Chu-bin1
（1.Department of Pathology，Zhuhai People′s Hospital，Zhuhai 519000，Guangdong Province，China；2.Department of Endoscopy Room，Zhuhai People′s Hospital，Zhuhai 519000，Guangdong Province，China）
关键词:
结直肠微小息肉; 结直肠微小腺瘤; 活检钳息肉冷切除术; 富士智能染色内镜; 放大内镜; 组织病理学; 内镜下黏膜切除术; 完全切除率
Keywords:
diminutive colorectal polyps; diminutive colorectal adenomas; cold forceps polypectomy; Fujinon intelligent chromoendoscopy; magnified endoscopy; histopathology; endoscopic mucosal resection; complete resection rate
分类号:
R735.3
DOI:
10.7683/xxyxyxb.2016.08.006
文献标志码:
A
摘要:
目的　探讨富士智能染色内镜（FICE）及放大内镜（ME）模式下标准活检钳冷切除（CFP）结直肠微小腺瘤的组织学完全切除率。方法　选取珠海市人民医院2015年随访性、筛查性及症状性结肠镜检查的212例患者为研究对象，共发现结直肠微小息肉（DCP） 274个，其中内镜诊断为结直肠微小腺瘤（DCA） 164个。首先使用FICE+ME观察DCP的表面微结构，符合DCA诊断标准者使用CFP切除DCA，切除部位用生理盐水反复冲洗直至渗血停止；之后使用FICE+ME详细观察切除部位，如果发现腺瘤组织残留，重复这一过程，直至腺瘤完全切除，之后以切除部位边缘外侧2～3 mm处为切割线进行内镜下黏膜切除术（EMR），并将CFP与EMR切除的标本同时送病理检查，评估CFP治疗DCA的组织学完全切除率。结果　DCA的总体组织学完全切除率为97.5%，直径≤3 mm DCA的组织学完全切除率为100.0%，3～5 mm DCA的组织学完全切除率为91.3%；直径≤3 mm的DCA组织学完全切除率高于直径3～5 mm 的DCA（χ2=10.17，P=0.006）。多因素回归分析显示，息肉的大小是影响CFP治疗DCA组织学完全切除率的唯一因素［OR 4.1；95% CI（2.53，15.42），P=0.009］。CFP术后均发生少量渗血，出血均可自行停止；所有患者均未发生迟发性出血及穿孔。结论　FICE+ME详细观察CFP术后创面可以提高CFP治疗DCA的组织学完全切除率。CFP联合FICE+ME适用于绝大多数DCA的治疗，尤其是直径≤3 mm的DCA。
Abstract:
Objective　To evaluate the complete histological resection rate of diminutive colorectal adenomas by standard biopsy forceps combined with Fujinon intelligent chromoendoscopy（FICE） and magnified endoscopy（ME）.Methods　A total of 212 patients with diminutive polyps were screened in 2015.A total of 274 diminutive colorectal polyps（DCP） were detected，and 164 polyps were diminutive colorectal adenomas（DCA）.Surface microstructural of DCP was observed by FICE and ME，cold biopsy forceps polypectomy（CFP） was used to resect DCA which was conform to the diagnostic criteria of DCA，the removal of position was douched with normal saline repeatedly until no adenomas was visible.Than the removal of position was observed by FICE and ME，if there was residual adenoma tissue，the above process was repeated until the adenoma tissue was completed excised.Each polyp base was then resected using endoscopic mucosal resection（EMR） with a 2-3 mm free margin.Specimens which was excised by CFP and EMR were sent to the histopathology department for the evaluation of the complete resection rate.Results　The complete resection rate of DCA was 97.5%.The complete resection rate for ≤3 mm adenomas was 100.0%.The complete resection rate for 3-5 mm adenomas was 91.3%.The complete resection rate of adenomatous polyps ≤3 mm was higher than that of adenomatous polyps >3 mm（χ2=10.17，P=0.006）.The results of multi-factor regression analysis showed that polyp size was the only factor for the complete resection rate［OR 4.1；95% CI（2.53，15.42），P=0.009］.All of them had small bleeding after CFP，and all cases quitted spontaneously.There were no complications such as delayed bleeding or perforation due to colonoscopy or polypectomy.Conclusion　The complete resection rate of DCA is improved by using CBP combined with FICE and ME.CBP appears to be adequate for the resection of the majority of DCA，especially small sized adenomas（≤3 mm）.

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更新日期/Last Update: 2016-08-05