【摘要】 目的 :探讨内镜粘膜切除术 (Endoscopic Mucosal Resection:EMR)在结直肠肿瘤诊治中的临床应用价值。方法 :对 1 996年 6月～ 1 998年 2月间电子肠镜检出的 34例 38个病变行 EMR,并比较 EMR标本与普通活检标本对早期癌的检出率。结果 :对 34例 38个病变施行 EMR成功 37次 ,失败 1次 ,成功率 97.4% (37/ 38)。成功的 37次中包括分割切除 (Endoscopic Picemeal MucosalResection:EPMR) 9次 .EPMR术中并发少量出血 2例 (5.4% )。病理检查发现多发息肉癌变率(1 0 0 % )高于单发息肉 (2 9.41 % ) ,P=0 .0 0 1 .肿瘤最大径 <1 .5cm腺瘤癌变率为 36 .37% (8/ 2 2 )、≥ 1 .5cm为 73.33% (1 1 / 1 5) ,P=0 .0 45;EMR标本与普通活检标本对早期癌的检出率分别是52 %和 2 6 % (P<0 .0 0 1 ) ,而且普通活检的漏检率达 50 % (8/ 1 6病变 )。结论 :内镜下大肠粘膜切除术能够对常规圈套法不能摘除的肿瘤样病灶切取活检 ,以达到病理学诊断定性质、定范围、定深度的理想要求 ,且对早期大肠癌的检出率优于普通活检更多还原

【Abstract】 Objective: To investigate the value of Endoscopic Mucosal Resection(EMR) in dignosis and treatment of colorectal neoplastic lesions.Methods: Thirty eight lesions from 34 patients were removed by the EMR. The results of the EMR specimens and those from routine biopsy were compared. Results: EMR was successfully performed in 37 lesions and failed once with a success rate of 97.4%(37/38). Among 37 successful EMR 9 were Endoscopic Picemeal Mucosal Resection (EPMR). Two (5.4%) cases were complicated by bleeding. The conceration rate of multiple polyps was higher than that of single polyps (100% Vs 29.4%, P =0.001). The maximum diameter of tumor was positively correlation with the rate of canceration, the rate of lesion <l.5 cm was 36.4%(8/22) and that of lesion≥1.5 cm was 73.3%(11/15, P =0.045 ); The early cancer rate of EMR samples and that of routine biopsy samples were 52%(16/31) and 26%(8/31), respectively( P =0.001). Conclusion: EMR can take biopsy which can not be taken by routine operation. The early detection rate of cancer by EMR is higher than that by routine operation.更多还原