ENDOSCOPIC BIOPSY HAS LIMITED ACCURACY IN DIAGNOSIS OF AMPULLARY TUMORS
ENDOSCOPIC BIOPSY HAS LIMITED ACCURACY IN DIAGNOSIS OF AMPULLARY TUMORS
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DOI：
10.1016/s0016-5107(90)71170-4
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发表时间：
1990-11-01
影响因子：
7.7
通讯作者：
KITAMURA, K
中科院分区：
文献类型：
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作者：
YAMAGUCHI, K;ENJOJI, M;KITAMURA, K
我们回顾性分析了78例日本壶腹肿瘤患者的内镜活检标本和手术切除标本，以探讨内镜活检的临床意义。内镜活检标本根据上皮异型程度分为5组：1组（无异型）、2组（轻度异型）、3组（中度异型或腺瘤）、4组（严重异型或原位癌）、5组（浸润性癌）。78例切除的壶腹部肿瘤最终诊断为腺瘤5例，癌27例，腺瘤和癌兼有46例。在73例癌症病例中，肿瘤（4组或5组）的活检准确率为70%（51 / 73）。壁内突出型活检准确率为50%(7 / 14)，暴露突出型为64%(21 / 33)，溃疡型为88%（23 / 26）。5例壶腹腺瘤中，腺瘤（3组）的诊断正确率为80%（4 / 5）。在73例癌病例中，18例（25%）活检诊断为腺瘤（3组），而在手术切除标本的较深层发现癌。腺瘤的活检诊断不能排除壶腹肿瘤深部癌的可能性。
Endoscopic biopsy specimens and surgically resected specimens in a collective series of 78 Japanese patients with ampullary tumor were retrospectively reviewed to investigate the clinical implications of endoscopic biopsy. Endoscopic biopsy specimens were classified into five groups based on the degree of epithelial atypia: group 1 (no atypia), group 2 (mild atypia), group 3 (moderate atypia or adenoma), group 4 (severe atypia or carcinoma in situ), and group 5 (invasive carcinoma. Final diagnosis of the 78 resected ampullary tumors was adenoma in five cases, carcinoma in 27 cases, and both adenoma and carcinoma in 46 cases. Biopsy accuracy of carcinoma (group 4 or 5) was 70% (51 of 73) overall in 73 carcinoma cases. Biopsy accuracy was 50% (7 of 14) in the intramural protruding type, 64% (21 of 33) in the exposed protruding type, and 88% (23 of 26) in the ulcerating type. The diagnostic accuracy of adenoma (group 3) was 80% (4 of 5) in fiv cases of ampullary adenoma. In 18 (25%) of the 73 carcinoma cases, biopsy diagnosis was adenoma (group 3), whereas carcinoma was found in the deeper layers of surgically resected specimens. Biopsy diagnosis of adenoma does not rule out the possibility of deeper carcinoma in ampullary tumors.