胃镜活检与外科病理诊断胃癌临床对比分析

目的 对比分析胃镜活检与外科病理对胃癌诊断结果的差异. 方法选取2009年8月～2012年8月我院收治的胃癌患者47例,对胃镜活检和术后组织病理学进行对比分析. 结果以手术后组织病理学诊断结果为标准,胃镜活检的确诊率为78.7%,疑诊率为12.8%,未能确诊率为8.5%;胃镜活检确诊率以Borrmann I型病变最高为100%,其次分别为Borrmann Ⅱ型和Borrmann Ⅲ型,确诊率分别为75.0%和66.7%,最低的病变类型为Borrmann Ⅳ型,确诊率仅为20.0%;胃镜活检对分化型癌细胞的判断准确率较高（89.7%）,而对分化不良型癌细胞的判断准确率相对较低（37.5%）. 结论胃镜活检对于胃癌的诊断具有重要的临床价值,但取材有限,难以全面客观反映病变性质,特别对弥漫浸润型黏膜病变和分化不良型癌细胞的诊断误差较大,需要引起重视.

Comparison of diagnosis of gastric carcinoma by gastroscopy biopsy and surgical pathology

Objective To compare the diagnosis of gastric carcinoma by gastroseopy biopsy and surgical pathology. Methods A total of 47 cases of patients with gastric carcinoma from August 2009 to August 2012 in our hospital were selected, the gastroseopy biopsy and surgical pathology were analyzed. Results According to the results of surgical pathology as the standard, the diagnosis rate of gastroseope biopsy was 78.7%, suspected rate was 12.8%, and failure diagnosis rate was 8.5%; Gastroscope biopsy which Borrmann I type of the highest rates of disease diagnosis, diagnosis rate of 100%, Borrmann lI and Borrmann HI type followed for the diagnosis rate 75.0% and 66.7%, Borrmann IV type confirmed a lower rate 20.0%; Gastroseope biopsy of the tumor differentiated degree of histological confirmed a high rate of diagnosis rate of 89.7%, but the undifferentiated carcinoma cells of histological confirmed a low rate （37.5%）. Conclusion The clinical value of gastroseopy biopsy pathology in the diagnosis of gastric cancer are important, but the source is limited, it is difficult to comprehensively and objectively reflect the nature of the lesions, especially for the diffuse infiltrative gastric mucosal lesion and undifferentiated cancer cells, the diagnosis error is large, and needs to pay attention to.