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| 1 | 老年人结直肠侧向发育型肿瘤恶变相关危险因素分析显示文摘目的探讨老年人(年龄≥60岁)结直肠侧向发育型肿瘤(lateral spreading tumors,LST)合并高级别上皮内瘤变(high grade intraepithelial neoplasm,HGIN)或癌变的相关危险因素。方法回顾性分析2013年1月-2019年6月在福建省立医院经内镜诊断并治疗的212例年龄≥60岁的LST患者临床资料,分析病变病理性质与患者的一般临床特征(年龄、性别、体重指数、吸烟史、饮酒史、基础疾病、服用抗凝药物情况、血脂情况、癌胚抗原水平)及内镜下表现(大小、部位、形态等)的相关性,并分析总结老年人LST合并HGIN或癌变的相关危险因素。结果纳入的212例患者男119例、女93例,年龄(68.76±6.37)岁,病灶大小(26.10±15.64)mm,内镜治疗204例(96.2%),外科治疗8例(3.8%),内镜下治愈性切除率99.5%(203/204)。术后病理提示HGIN占34.9%(74/212),癌变占7.6%(16/212)。单因素Logistic回归分析显示,患者的年龄、性别、体重指数、吸烟史、饮酒史、基础疾病、是否服用抗凝药、血脂情况、癌胚抗原水平均不是LST合并HGIN或癌变的相关危险因素(P>0.05),病灶大小(P<0.001)、病灶位置(P=0.002)、病灶形态(P<0.001)是LST合并HGIN或癌变的危险因素。多因素Logistic回归分析显示,病灶大小≥20 mm(P=0.001),病灶形态为结节混合型(P=0.020,OR=2.624,95%CI:1.161~5.933)或假凹陷型(P=0.012,OR=10.009,95%CI:1.667~60.080)是老年人LST合并HGIN或癌变的危险因素。结论对年龄≥60岁的LST患者,病灶大小及形态是LST合并HGIN或癌变的独立危险因素,临床应重视老年人的结肠镜检查及早期诊疗。 | 许炎钦 林峥嵘 钟世顺 郑金辉 梁玮 | 2020 | 中华消化内镜杂志2020，37，12： | 4 |
| 2 | Clinical study using novel endoscopic system for measuring size of gastrointestinal lesion显示文摘AIM:To verify the performance of a lesion size measurement system through a clinical study.METHODS:Our proposed system,which consists of a conventional endoscope,an optical device,an optical probe,and a personal computer,generates a grid scale to measure the lesion size from an endoscopic image.The width of the grid scale is constantly adjusted according to the distance between the tip of the endoscope and lesion because the lesion size on an endoscopic image changes according to the distance.The shape of the grid scale was corrected to match the distortion of the endoscopic image.The distance was calculated using the amount of laser light reflected from the lesion through an optical probe inserted into the instrument channel of the endoscope.The endoscopist can thus measure the lesion size without contact by comparing the lesion with the size of the grid scale on the endoscopic image.(1)A basic test was performed to verify the relationship between the measurement error eM and the tilt angle of the endoscope;and(2)The sizes of three colon polyps were measured using our system during endoscopy.These sizes were immediately measured by scale after their removal.RESULTS:There was no error atα=0°.In addition,the values of eM(mean±SD)were 0.24±0.11 mm(α=10°),0.90±0.58 mm(α=20°)and 2.31±1.41mm(α=30°).According to these results,our system has been confirmed to measure accurately when the tilt angle is less than 20°.The measurement error was approximately 1 mm in the clinical study.Therefore,it was concluded that our proposed measurement system was also effective in clinical examinations.CONCLUSION:By combining simple optical equipment with a conventional endoscope,a quick and accurate system for measuring lesion size was established. | Kiyoshi Oka Takeshi Seki Tomohiro Akatsu Takao Wakabayashi Kazuo Inui Junji Yoshino | 2014 | World Journal of Gastroenterology2014，20，14： | 1 |
| 3 | CT结肠镜中肿瘤形态在结直肠肿瘤浸润深度评估中的价值显示文摘【目的】探索CT结肠镜中肿瘤形态在结直肠肿瘤浸润深度评估中的价值。【方法】入组病理证实为Tis-T2的结直肠癌病灶,所有病灶治疗前均具有良好的CT结肠镜图像质量。由一位影像科医生进行影像评估,评估的指标包括肿瘤的部位、大小、蒂和溃疡。其中肿瘤部位分为直肠和结肠两类;蒂分为有蒂、亚蒂和无蒂三类;溃疡根据有无分为两类。分别比较不同浸润深度肿瘤在肿瘤部位、肿瘤大小、蒂的形态和溃疡有无中的差异。【结果】总共入组242个结直肠肿瘤病灶,其中Tis、T1a、T1b、T2a和T2b分别为43、21、35、62和81个。结肠与直肠在肿瘤浸润深度各组中具有相似的比例,但直肠肿瘤黏膜下深层浸润的比例显著高于结肠肿瘤。肿瘤的大小在Tis-T2a中无显著性差异,均显著小于T2b。肿瘤蒂的形态是肿瘤深层浸润的保护因子,随着蒂形态的消失,肿瘤浸润深度逐渐加重,两者间存在中等程度相关。Tis与其他期肿瘤相比,有蒂和亚蒂的比例最高,显著高于其他期肿瘤;T1a和T1b两组蒂的形态没有显著性差异,但与T2a和T2b相比存在显著性差异;而T2a和T2b两组蒂的形态没有显著性差异。溃疡是肿瘤黏膜下深层浸润的重要征象,存在溃疡的肿瘤其黏膜下深层浸润的比例高达95.92%。分别以蒂的形态和溃疡作为因变量,其预测结直肠肿瘤黏膜下深层浸润的受试者工作特性曲线(receiver operating characteristic curve,ROC)下面积分别为0.780和0.849。【结论】肿瘤蒂的形态和溃疡在结直肠肿瘤浸润深度评估中具有重要价值。 | 姜军 徐天磊 周纯武 | 2019 | 武警后勤学院学报(医学版)2019，28，8： | 1 |
| 4 | 大肠癌合并糖尿病患者术后并发症发生的危险因素Logistic回归分析显示文摘糖尿病(DM)是一种病因未明的内分泌代谢性疾病,高血糖为其主要临床特征。大肠癌死亡率位居所有恶性肿瘤的第4位,并逐年上升。近年来,大肠癌术后5年生存率仍徘徊在30%~50%,由于在大肠癌早期诊断、复发转移、预后评估等方面不完善,其总体疗效改善不佳。 | 李强 熊伟 栗明 夏翠锋 董建华 | 2012 | 中国老年学杂志2012，32，18： | 0 |
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