摘要目的 探讨内镜测量结直肠侧方发育肿瘤(LST)直径的准确性及临床应用价值.方法 选取2013年8月至2014年10月南京中医药大学第三附属医院收治的54例结直肠LST患者进行前瞻性研究.行内镜检查确定为结直肠LST后,采用内镜下刻度活组织检查钳、内镜下测量系统和病理学检查分别测量结直肠LST的纵轴和横轴长度.采用门诊和电话方式进行随访,随访时间截至2014年12月.符合正态分布的计量资料采用(x)±s表示,多组间比较采用方差分析,两两比较采用LSD-t检验.结果 筛选出符合研究条件的患者54例.54例患者共检出结直肠LST 62枚,其中横结肠息肉1枚,升结肠和盲肠息肉13枚,降结肠息肉6枚,乙状结肠息肉24枚,直肠息肉18枚.采用内镜下刻度活组织检查钳测得62枚结直肠LST的纵轴长度为(1.1±0.5)cm,内镜下测量系统为(1.1±0.5)cm,病理学检查为(1.0±0.4)cm,3者比较,差异无统计学意义(F=1.306,P＞0.05).采用内镜下刻度活组织检查钳测得62枚结直肠LST的横轴长度为(1.1±0.6)cm,内镜下测量系统为(0.7±0.4)cm,病理学检查为(0.7±0.4)cm,3者比较,差异有统计学意义(F=9.214,P＜0.05).内镜下刻度活组织检查钳测得结直肠LST的横轴长度与内镜下测量系统和病理学检查分别比较,差异均有统计学意义(t =7.074,9.852,P＜0.05).54例患者术后均获得随访.中位随访时间为10个月(2 ～16个月).54例患者均健康生存,无肿瘤残留、复发和癌变.结论 采用内镜下刻度活组织检查钳和内镜下测量系统测量结直肠LST纵轴长度准确可靠,而测量横轴长度,采用内镜下测量系统更准确.

abstractsObjective To investigate the accuracy and application value of endoscopic polyp size measurement of colorectal lateral spread tumor (LST).Methods The clinical data of 54 patients with colorectal LST who were admitted to the Third Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from August 2013 to October 2014 were prospectively analyzed.Disposable graduated biopsy forceps (DGBF) and endoscopic lesion measurement system (ELMS) were used to evaluate the length and width of LST and the results were compared with the actual size after resection.Patients were followed up via outpatient examination or telephone interview till December 2014.Data with normal distribution were expressed by x ± s,and were analyzed using the ANOVA or the LSD-t test.Results Fifty-four patients were enrolled in the study.Sixty-two LSTs were detected in the 54 patients,including 1 ployp in transverse colon,13 ployps in ascending colon and cecum,6 ployps in descending colon,24 ployps in sigmoid colon and 18 ployps in rectum.The average length of the LST was (1.1 ±0.5)cm measured by the DGBF,(1.1 ±0.5)cm by the ELMS and (1.0 ±0.4)cm by the pathological examination,with no significant difference (F =1.306,P ＞ 0.05).The mean width of the LST was (1.1 ±0.6)cm by the DGBF,(0.7 ±0.4)cm by the ELMS and (0.7 ±0.4)cm by the pathological examination,with significant difference (F =9.214,P ＜ 0.05).There was significant difference in the width of the LSTs measured by the DGBF between that measured by the ELMS and by the pathological examination (t =7.074,9.852,P ＜ 0.05).All the 54 patients were followed up with the median time of 10 months (range,2-16 months).All the 54 patients were well survived without residual LSTs or recurrence and canceration of LSTs.Conclusions DGBF and ELMS could accurately measure the length and width of the LSTs,while DGBF is more accurate to measure the width of the LSTs.