目的：分析表浅型食管癌及上皮内瘤变的胃镜下分型表现与活检病理及手术病理的差异的相关性。方法：收集我院2008年1月至2014年12月期间胃镜下诊断为早期食管病变而活检病理为食管鳞癌或上皮内瘤变的120例手术患者的胃镜标本及手术标本，分析其胃镜下分型与活检病理及手术病理的差异的关系。结果：活检病理与术后病理间完全符合的占60.0%(72/120)，加重的占37.5%(45/120)，减轻的占2.5%(3/120)。表浅鳞癌组符合率90.5%，上皮内瘤变组26.3%，二者具显著差异(P<0.05)。而胃镜下1型符合率高(70.0%)，3型最低(42.9%)，具有统计学意义(P<0.05)。而且1、2、3型患者术后病理分析结果显示早期黏膜内及黏膜下浸润(深度及转移)具有明显递增现象，合并溃疡时均易出现横向纵深浸润进展及淋巴转移。结论：表浅型食管癌术前术后病理存在一定差异，而胃镜下分型表现与该差异程度有一定关系，并对病变浸润及分化程度有重要提示价值。%Objective: To analyze the correlation of classification and performance under gastroscope of superficial esophageal cancer and intraepithelial neoplasia and differences between biopsy pathology and surgical pathology. Methods: Totally 120 specimens of gastroscope and surgery were collected from January 2008 to December 2014, which diagnosed as early esophageal lesions by endoscopy, and conifrmed as esophageal squamous cell carcinoma or precancerous lesions by pathology. Then analyzed the correlation of classification and performance under gastroscope and differences between biopsy pathology and surgical pathology.Results:The biopsy pathology which was completely in conformity with postoperative pathology was 60% (72/120), while the exacerbation was accounted for 37.5% (45/120) and the alleviation was accounted for 2.5% (3/120). hTe coincidence rate of superficial esophageal squamous cell carcinoma (SESCC) group was 90.5%, while the intraepithelial neoplasia group was 26.3%. hTere was a signiifcant difference between them (P<0.05). hTe coincidence rate of type 1 was higher than type 3 (70% vs. 42.9%,P<0.05). hTe postoperative pathological analysis results of type 1, 2, 3 patients showed that there had an obvious increasing phenomenon in early mucous membrane and submucous inifltration (depth and transfer). It’s much easier to have a transverse deep inifltration and lymphatic metastasis when merging ulcer.Conclusion: Some differences existed between preoperative and postoperative pathology in SESCC. However, there had a certain relationship between gastroscopic classiifcation and difference degree and provided an important clinical value in the involvement and differentiation of early esophageal lesions.
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