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目的介绍 WHO(2000年)对结直肠上皮内瘤变和癌的活检诊断标准,旨在避免过度或过低诊断。方法根据 WHO(2000年)对结直肠上皮内瘤变和癌的活检诊断标准,对2001年1月至2005年10月间,56例手术标本诊断为癌和上皮内瘤变的病理切片及同一患者术前活检切片进行对照研究。结果 56例患者中术前活检诊断原位癌、黏膜内癌、腺瘤癌变16例,根据新标准有14例应更正为高级别上皮内瘤变。结论根据 WHO(2000年)对结直肠上皮内瘤变和癌的活检诊断标准,可避免过度诊断;但对活检见不到黏膜肌的病例须紧密结合临床各项检查进行综合诊断,以免造成过低诊断导致贻误治疗。
Objective To introduce WHO (2000) diagnostic criteria for biopsy of colorectal intraepithelial neoplasia and cancer aimed at avoiding over- or under-diagnosis. Methods According to WHO (2000) diagnostic criteria of colorectal intraepithelial neoplasia and cancer biopsy, from January 2001 to October 2005, 56 cases of surgical specimens were diagnosed as pathological sections of carcinoma and intraepithelial neoplasia and the same Patients with biopsy biopsy before the control study. Results 56 cases of preoperative biopsy diagnosis of carcinoma in situ, mucosal cancer, adenoma in 16 cases, according to the new standard 14 cases should be corrected for high-grade intraepithelial neoplasia. Conclusion According to WHO (2000) diagnostic criteria for colorectal intraepithelial neoplasia and cancer biopsy, over diagnosis can be avoided; however, the cases of mucosal muscle that do not have biopsy should be closely combined with the clinical examination in order to avoid Low diagnosis leads to delaying treatment.