想必昨天的22個病例都看過了吧,，有沒有疑惑沒有看出來的,？有沒有嚇出一身冷汗的？我粗略統(tǒng)計了一下,，以下是較為普遍存在困惑的病例,。一起來看一下吧：

【白光加染色重點(diǎn)難點(diǎn)病例】

CASE2

This specimen was resected by endoscopic mucosal resection using a cap (EMR-C). Cancer was visualized at the region indicated by the arrows

Higher magnification： Well-differentiated adenocarcinoma was observed in the mucosa

early gastric cancer, lesser curvature of the mid-body, type 0-IIa, 4-mm well-differentiated tubular adenocarcinoma (tub1).

CASE4

early gastric cancer, greater curvature of the upper body (remnant stomach), type 0-IIb,3-mm signet-ring cell carcinoma (sig).

The lesion was completely resected in one piece by EMR

Histology: depth M, sig, ly0, v0, l-ce(?), v-ce(?)

CASE6

early gastric cancer, lesser curvature of the antrum, type 0-IIc, 5-mm well-differentiated tubular adenocarcinoma (tub1).

CASE7

early gastric cancer, lesser curvature of the mid-body, type 0-IIc, 5-mm well-differentiated tubular adenocarcinoma (tub1). 

The lesion was completely resected in one piece by EMR：tub1, depth M, ly0, v0, l-ce(?), v-ce(?)

CASE14

early gastric cancer, greater curvature of the antrum, type 0-IIc, 5-mm moderately

differentiated adenocarcinoma (tub2).

CASE16

early gastric cancer, lesser curvature of the antrum, type 0-IIc, 3-mm moderately differentiated adenocarcinoma (tub2). 

Histology:depth M, tub2, ly0, v0, v-ce(?), l-ce(?)

CASE17

early gastric cancer, greater curvature of the antrum, type 0-IIc, 10-mm signet-ring

cell carcinoma (sig).

Histology: depth M, por2, sig, ly0, v0, L-ce(?), v-ce(?)

CASE20

early gastric cancer, posterior mid-body, type 0-IIc, 2-mm signet-ring cell carcinoma(sig).

Histology: depth M, sig, 2 mm, ly0, v0, v-ce(?), l-ce(?)

CASE21

early gastric cancer, lesser curvature of the lower body, type 0-IIc, 5-mm signet-ring cell carcinoma (sig).

CASE22

Biopsy specimen: Glandular density was high, and glandular atypia was recognized. Nuclei of the glands with atypia were swollen, and a multilayered structure was evident. These fi ndings are characteristic of well-differentiated adenocarcinoma

ESD specimen: Well-differentiated adenocarcinoma was observed in only one specimen, and an intramucosal cancer, 2 mm in diameter, was present. Thickening of the muscularis mucosae close to the lesion (possibly a change due to the biopsy) was observed (arrows). It is probable that part of the lesion was removed by biopsy, so the lesion is now smaller

early gastric cancer, posterior angle, type 0-IIc, 5-mm well-differentiated tubular

adenocarcinoma (tub1).

有沒有這樣的感嘆：普通胃鏡都不敢做了，不知道以前漏診了多少早癌,，靛胭脂是多么重要,，白光是多么重要......

過去的就讓他過去吧，至少從今往后,，細(xì)致,，再細(xì)致得做你手下的每一個胃鏡，態(tài)度決定一切,，眼睛決定水平,。凡事，盡力就好,。

記住睜大眼睛：早癌你見與不見,，它就在那里！

謝謝開號兩月來大家對一聽的支持

近日可能由于小變故更新會不定時