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直肠腺癌术前分化程度与分级准确率的比较研究
引用本文:刘峰,王颢,郑建明,傅传刚. 直肠腺癌术前分化程度与分级准确率的比较研究[J]. 中华胃肠外科杂志, 2010, 13(8): 577-579. DOI: 10.3760/cma.j.issn.1671-0274.2010.08.008
作者姓名:刘峰  王颢  郑建明  傅传刚
作者单位:1. 第二军医大学附属长海医院肛肠外科,上海,200433
2. 第二军医大学附属长海医院病理科,上海,200433
基金项目:上海市科委项目,第二军医大学2009年大学生创新能力培养计划项目 
摘    要:
目的 对直肠腺癌术前活检分化程度及分级的准确率进行比较,以指导临床工作.方法 收集上海长海医院2006年3月至2008年5月间收治的100例直肠腺癌病例资料进行回顾性研究,由一位病理科教授对术前活检组织切片和术后病理切片重新测片,将高、中分化归为低度恶性肿瘤,低和未分化归为高度恶性肿瘤,对直肠腺癌进行分级,确定术前活检分化程度的准确率.结果 本组患者术前分化程度的准确率为72%.术前活检分化偏高的病例占20%,偏低的病例占8%.术前直肠癌分级准确率为91%,术前分级偏低者占5%,偏高者占4%(P〈0.01).结论 术前直肠腺癌活检分级准确率较高.

关 键 词:直肠肿瘤  活组织检查  细胞分化

Accuracy comparison of preoperative histological assessment in differentiation and grading of rectal adenocarcinoma
LIU Feng,WANG Hao,ZHENG Jian-ming,FU Chuan-gang. Accuracy comparison of preoperative histological assessment in differentiation and grading of rectal adenocarcinoma[J]. Chinese journal of gastrointestinal surgery, 2010, 13(8): 577-579. DOI: 10.3760/cma.j.issn.1671-0274.2010.08.008
Authors:LIU Feng  WANG Hao  ZHENG Jian-ming  FU Chuan-gang
Affiliation:.(Department of Colorectal Surgery, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China)
Abstract:
Objective To compare the accuracy of preoperative assessment in differentiation and grading of rectal adenocarcinoma. Methods One hundred consecutive patients diagnosed as invasive rectal cancer by colonoscopy biopsy and undergone operation in the Changhai Hospital from March 2006 to May 2008 were studied retrospectively. Patient characteristics, examination records. operative and pathologic reports were reviewed. The slides of preoperative biopsy and postoperative pathologic specimen were reviewed to identify the differentiation by a single pathologist. The results of preoperative biopsy were compared to those of postoperative specimen which was considered as final diagnosis. The accuracy of preoperative assessment of differentiation was calculated. Patients were then divided into two groups based on the preoperative differentiation: the low-grade tumor including well and moderately differentiated tumors, and the high-grade tumor consisting of poorly differentiated and undifferentiated tumors. The accuracy of grading was also calculated. Results The accuracy of preoperative assessment of differentiation was 72%,with 20%overgrading and 8%undergrading.while the accuracy of preoperative grading was 91%,with 4%overgrading and 5%undergrading.The accuracy of grading was significantly higher than that of specific differentiation (P<0.01).Conclusion The grading of preoperative biopsy has high accuracy rate and should be considered in clinical practice.
Keywords:Rectal neoplasms  Biopsy  Cell differentiation
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