表浅胃食管交界腺癌内镜分型与浸润深度相关性分析

Correlation Between Endoscopic Macroscopic Type and Depth of Tumor Invasion for Superficial Adenocarcinoma of Esophagogastric Junction

中文关键词:  浅表型食管癌 食管上皮内瘤变 内镜黏膜下切除 病理特征

英文关键词:Superficial adenocarcinoma of esophagogastric junction Endoscopic macroscopic type Depth of tumor invasion

中文摘要:

      目的 探讨表浅胃食管交界腺癌（AEG）的临床病理特征与术后浸润深度之间的关系，评估表浅AEG的内镜分型对预测浸润深度的意义。方法 分析2008年11月至2015年5月期间四川大学华西医院行内镜治疗或外科手术并经病理确诊的57例表浅AEG患者的临床病理资料，对其与浸润深度的关系进行分析。结果 患者年龄48~76岁，平均（63.0±6.8）岁；男49例，女8例。肿瘤直径为3.0~40.0 mm，平均（16.6±10.1） mm。黏膜内癌28例，黏膜下癌29例。两组年龄、性别、组织学分型、Siewert分型差异无统计学意义，肿瘤直径（ P=0.02）和内镜分型（ P=0.02）差异有统计学意义。进一步行多因素logistic回归分析显示，内镜分型为黏膜下层浸润的独立危险因素( P=0.041)，凹陷型表浅AEG发生黏膜下层浸润的风险是隆起型或平坦型的3.244倍(95%可信区间1.050～10.023)。结论 表浅AEG的内镜分型对浸润深度的判断有一定意义。对于内镜分型以凹陷为主型的表浅AEG，特别是0-Ⅲ型，多有黏膜下层的浸润，其发生淋巴结转移风险高，不建议行内镜下治疗。

英文摘要:

      Objective To develope a method of solvent demulsification dispersive liquid phase microextraction (SD-DLPME) based on ion association reaction coupled with graphite furnace atomic absorption spectroscopy (GFAAS) for detecting thallium in water samples. Methods Thallium ion in water samples was oxidized to Tl(Ⅲ) with bromine water, which reacted with Cl^- to form TlCl₄^-. The ionic associated compound with trioctylamine was obtained and extracted. DLPME was completed with ethanol as dispersive solvent. The separation of aqueous and organic phase was achieved by injecting into demulsification solvent without centrifugation. The extractant was collected and injected into GFAAS for analysis. With palladium colloid as matrix modifier, a two step drying and ashing temperature programming process was applied for high precision and sensitivity. Results The linear range was 0.05-2.0 μg/L, with a detection limit of 0.011 μg/L. The relative standard derivation (RSD) for detecting Tl in spiked water sample was 9.9%. The spiked recoveries of water samples ranged from 94.0% to 103.0%. Conclusion The method is simple, sensitive and suitable for batch analysis of Tl in water samples.