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目的 分析结、直肠癌内窥镜活检组织腺癌的病变特点,总结临床病理特征,提高活检诊断率.方法 通过切片HE染色对238例腺癌标本进行组织学分析,按照WHO诊断标准,必须存在黏膜肌层浸润到黏膜下层的特点诊断为结、直肠癌,并于手术根治切除标本病理诊断相对比,活检部分病例进行免疫组化标记actin、desmine、SMA确定平滑肌组织.结果 1 441例活检标本中238例诊断为腺癌,其中153例行根治性切除,其中62例(40.5%)活检不能肯定浸润黏膜下层,腺瘤癌变局限在黏膜内3例,浸润肌层5例.结论 结、直肠腺癌活检组织对不确定浸润黏膜下层的病例不使用黏膜内瘤变,事实上这些病例绝大多数是浸润性癌.内窥镜及外科医生多取材、深取材,与病理医生多沟通是提高诊断的有效途径.“,”Objective To analyze the clinical pathologica diagnosis for biopsy of colorectal adenocarcinoma,increase the rate of biopsy diagnosis.Methods Two hundred and thirty-eight cases of colorectal adenocarcinoma specimens histological analysis According to the WHO criteria for diagnosis must muscularis mucosa,there was infiltration into the submucosa characteristics for the diagnosis of colorectal cancer,surgery and removal of pathology specimens compared.Part of the biopsy cases IHC actin,desmine,SMA determine to smooth musclethe organization.Results 1441 cases of biopsy specimens in 238 cases diagnosed as adenocarcinoma,in which 153 of the routine radical resection,62 cases of infiltration can not be sure submucosa diagnosed with cancer,accounting for 40.5%,adenoma cancer confined to the mucosa in 3 cases,muscular infiltration in 5 cases.Conclusion Colorectal cancer in endoscopic biopsy of uncertainty when carcinoma infiltrating submucosa of the cases do not use mucosal neoplasia,in fact,the vast majority of these cases are invasive cancer.Endoscopic doctors and surgeon drawn,deep drawn,to improve communication the pathologist is more effective way to diagnose.