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目的:探讨基于电子胃镜活检病理诊断伴幽门螺杆菌感染的胃黏膜上皮内瘤变的临床价值。方法:选取2011年1月至2016年1月在南阳市第二人民医院行电子胃镜活检病理诊断伴幽门螺杆菌感染的胃黏膜上皮内瘤变且行外科手术的患者120例,以外科手术病理诊断为对照,分析电子胃镜活检病理诊断的准确性。结果:120例患者均行电子胃镜活检及外科手术病理诊断,确认为胃浸润癌的患者116例,其中电子胃镜活检确诊28例,诊断为高级别上皮内瘤变的患者79例,两者占92.2%;对于肿瘤>2 cm、肿瘤高~中分化及内镜Ⅱ分型的患者,电子胃镜活检的相符率明显较低,差异具有统计学意义(P<0.05),而对于轻~中度胃炎患者,电子胃镜活检准确率较高,差异具有统计学意义(P<0.05)。结论:电子胃镜病理诊断可发现大部分胃部病变患者,电子胃镜活检病理诊断为高级别上皮内瘤变时,病变加重的可能性很大;肿瘤>2 cm、肿瘤高~中分化、内镜Ⅱ分型及重度胃炎都会使电子胃镜活检与外科手术病理诊断的相符率下降,故在临床上应对患者定期胃镜检查及病理活检,准确诊断出患者胃部疾病。
Objective: To investigate the clinical value of gastric mucosal intraepithelial neoplasia based on electron gastroscopy biopsy in the diagnosis of Helicobacter pylori infection. Methods: A total of 120 patients with gastric intraepithelial neoplasia diagnosed by Helicobacter pylori infection underwent electron endoscopy biopsy at the Second People’s Hospital of Nanyang City from January 2011 to January 2016 were selected and pathologically diagnosed As control, analyze the accuracy of electronic endoscopy biopsy diagnosis. Results: All the 120 patients were diagnosed by endoscopy and surgical pathology. One hundred and sixty-six patients were diagnosed as gastric invasive carcinoma, of which 28 were diagnosed by gastroscope biopsy and 79 were diagnosed as high-grade intraepithelial neoplasia, both of which accounted for 92.2%. The coincidence rate of electron endoscopy biopsy was significantly lower in patients with tumor> 2 cm, tumor with high-moderate differentiation and endoscopic type Ⅱ, the difference was statistically significant (P <0.05), but mild to moderate Gastritis patients, electron endoscopy biopsy accuracy rate was higher, the difference was statistically significant (P <0.05). Conclusion: The pathological diagnosis of electronic gastroscope can be found in most patients with gastric lesions, electronic endoscopy biopsy pathology diagnosis of high-grade intraepithelial neoplasia, the possibility of increased disease; tumor> 2 cm, high-grade tumor differentiation, endoscopic Ⅱ type and severe gastritis will make electronic gastroscopic biopsy and surgical pathology consistent rate of decline, so in clinical treatment of patients with regular endoscopy and biopsy, accurate diagnosis of gastric disease in patients.