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目的 :研究结直肠上皮内瘤样变病理诊断的临床意义。方法 :选取我院2014年6月—2015年9月收治的50例结直肠上皮内瘤样变病患者,经过诊断上皮内瘤样变低级的为20例,上皮内瘤样变高级的为30例。其中腺瘤切除的有6例,根治性的结肠切除有15例,直肠较低位切除的有20例,肛门部分切除的有5例,腹部会阴切除的有4例。结果 :在术后31例病例被确定为浸润性的腺癌,30例在术前诊断为上皮内瘤样变高级患者中,有86.67%术后病理为腺癌,在上皮内瘤样病变低级患者中有40%是侵润性的腺癌,31例腺癌中有4例伴有转移,2例附近的组织发生浸润,手术后病理被证实存在局部上的癌结节转移或淋巴结的有10例。结论 :要高度重视结直肠上皮内瘤变病理的诊断,警惕高级别上皮内瘤变为浸润性癌的可能性。
Objective: To study the clinical significance of pathological diagnosis of colorectal intraepithelial neoplasia. Methods: Fifty patients with colorectal intraepithelial neoplasia who were admitted to our hospital from June 2014 to September 2015 were selected. Twenty patients were diagnosed as having intraepithelial neoplasia with low grade and 30 with advanced intraepithelial neoplasia example. There were 6 cases of adenoma resection, 15 cases of radical colon resection, 20 cases of lower resection of rectum, 5 cases of resection of anus and 4 cases of abdomen perineum. Results: 31 cases were confirmed as invasive adenocarcinoma after surgery, 30 cases of advanced intraepithelial neoplasia diagnosed preoperatively, 86.67% of patients with pathological adenocarcinoma, in the low grade of intraepithelial neoplasia Forty percent of the patients had invasive adenocarcinoma, 4 of 31 cases of adenocarcinoma were associated with metastasis, and 2 were infiltrated with tissue adjacent to the tumor. The pathological findings after surgery were confirmed to be localized metastases to the nodules or lymph nodes 10 cases. Conclusion: To attach great importance to the diagnosis of colorectal intraepithelial neoplasia pathology, be alert to the possibility of high-grade intraepithelial neoplasia into invasive carcinoma.