食管早期癌及上皮内瘤变内镜分型与病理的关系

谢霞; 樊超强; 于劲; 杨歆; 邓磊; 廖忠莉; 杨仕明; 柏健鹰

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食管早期癌及上皮内瘤变内镜分型与病理的关系

论著 | 更新时间：2026-01-09

- 食管早期癌及上皮内瘤变内镜分型与病理的关系
- Relationship between endoscopic classification and pathology in early esophageal carcinoma and intraepithelial neoplasia
- 陆军军医大学学报 2014年36卷第24期页码：2496-2499
- 作者机构：
- 作者简介：
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  中图分类号： R730.2;R730.49;R735.1
- 纸质出版：2014
- 稿件说明：
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谢霞,樊超强,于劲,杨歆,邓磊,廖忠莉,杨仕明,柏健鹰.食管早期癌及上皮内瘤变内镜分型与病理的关系[J].陆军军医大学学报(原第三军医大学学报),2014,36(24):2496-2499.

　Xie Xia,Fan Chaoqiang,Yu Jin,Yang Xin,Deng Lei,Liao Zhongli,Yang Shiming,Bai Jianyin.Relationship between endoscopic classification and pathology in early esophageal carcinoma and intraepithelial neoplasia[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(24):2496-2499.
谢霞,樊超强,于劲,杨歆,邓磊,廖忠莉,杨仕明,柏健鹰.食管早期癌及上皮内瘤变内镜分型与病理的关系[J].陆军军医大学学报(原第三军医大学学报),2014,36(24):2496-2499. DOI：

　Xie Xia,Fan Chaoqiang,Yu Jin,Yang Xin,Deng Lei,Liao Zhongli,Yang Shiming,Bai Jianyin.Relationship between endoscopic classification and pathology in early esophageal carcinoma and intraepithelial neoplasia[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(24):2496-2499. DOI：

摘要

目的通过普通白光内镜及窄带成像放大内镜(narrow-band imaging combined with magnifying endoscopy NBI-ME) 观察早期食道癌及癌前病变的内镜分型

并探讨其与病理的关系。方法回顾性分析2011年3月至2014年7月行内镜下黏膜下剥离术治疗的早期食管癌和癌前病变患者的内镜分型及病理结果。结果 152例患者157处病灶纳入研究

其中上皮内乳头状毛细血管襻(intrapapillary capillaryloop，IPCL)为Ⅳ型的有12处

V1型有42处

V2有42处

V3有56处

Vn有5处

内镜下征象为 0-Ⅱa 型有34 处， 0-Ⅱb 型有95 处， 0-Ⅱc 型有22 处， 0～-Ⅱa+Ⅱc 型有6处。经病理组织证实低级别上皮内瘤变（low-grade intraepithelial neoplasia ，LGIN）为58处

高级别上皮内瘤变（high-grade intraepithelial neoplasia，HGIN）为54处

癌为45处。6.4%(10/157)侵犯黏膜下层浅层（sm1）

93.6%(147/157)局限于黏膜内。IPCL分型和病理组织的恶性程度具有相关性(列联系数C=0.559 2，P0.0５)

LGIN的IPCL以Ⅳ及V1型为主 LGIN以IPCL为Ⅳ及V1型为主

ＨGIN以V2及V3型为主

癌以V3及Vn为主

白光内镜下分型和病理的恶性程度具有相关性（列联系数C=0.496 8，P0.001），癌主要以0-Ⅱa型为主，ＨGIN及LGIN中以O-Ⅱb型为主。结论通过白光内镜及NBI-ME观察发现

白光内镜分型和病理具有相关性

癌主要以0-Ⅱa型为主，ＨGIN及LGIN中以O-Ⅱb型为主；IPCL分型也和病理组织的恶性程度具有相关性

LGIN的IPCL以Ⅳ及V1型为主

ＨGIN以V2及V3型为主

癌以V3及Vn为主，因此通过对5种食管黏膜IPCL的形态观察及内镜下分型可以推测病理组织学诊断，提高镜下对国人的早期食管癌及癌前病变诊断的准确率，以指导正确的治疗方法及镜下随诊。

Abstract

Objective To observe endoscopic classification of early esophageal cancer and precancerous lesions by ordinary white light endoscopy and narrow-band imaging combined with magnifying endoscopy (NBI-ME)

and evaluate the relationship between endoscopic classification and pathology. Methods Retrospective analysis of endoscopic classification and pathology was performed in patients with early esophageal cancer and precancerous lesions

who underwent endoscopic submucosal dissection (ESD) from March 2011 to June 2014. Results A total of 157 lesions from 152 subjects with early esophageal cancer and precancerous lesions were collected. Among them

12 Ⅳ type intrapapillary capillary loop (IPCL) patterns

42 V1 type IPCL patterns

42 V2 type IPCL patterns

56 V3 type IPCL patterns

and 5 Vn type IPCL patterns were detected by NBI-ME. There were 34 cases in 0-Ⅱa

95 cases in 0-Ⅱb

22 cases in 0-Ⅱc

and 6 cases in 0-Ⅱa + Ⅱc

which were detected by white light endoscopy. Of the 157 lesions

58 of low-grade intraepithelial neoplasia (LGIN)

54 of high-grade intraepithelial neoplasia (HGIN)

and 45 of carcinoma (Ca) were found. There were 6.4% (10/157) lesions invading the submucosa (sm1)

and 93.6% (147/157) lesions confined in the mucosa. The IPCL types were associated with the malignant degree of pathological tissue (C=0.559 2

P0.05). The IPCL patterns were mainly IV and V1 in LGIN

mainly V2 and V3 in HGIN

and mainly V3 and Vn in Ca. The endoscopic classification based on white light endoscopy was associated with the malignant degree of pathological tissue (C=0.496 8

P0.001). The endoscopic classification of Ca was mainly 0-Ⅱa

while HGIN and LGIN were mainly 0-Ⅱb. Conclusion The endoscopic classification based on white light endoscopy is associated with the pathological tissue

that is

Ca is mainly 0-Ⅱa

and HGIN and LGIN are mainly 0-Ⅱb. The IPCL types are also associated with the pathological tissue. The IPCL patterns of LGIN

HGIN and Ca were mainly Ⅳ and V1

mainly V2 and V3

and mainly V3 and Vn

respectively. The IPCL pattern observation and endoscopic classification of the esophageal lesions can roughly predict histopathological diagnosis

and improve the diagnosis accurate rate of esophageal cancer and precancerous lesions

so as to direct correct treatment and follow-up by endoscopy in our country.

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