讯享网

 <tbody> <tr> <td id="artContent" style="max-width: 656px;"> <div style="width: 656px; margin: 0; padding: 0; height: 0;"></div> <p style="text-align: center; visibility: visible;"><span style="visibility: visible;">【本公众号仅做为学习笔记使用】</span><span style="visibility: visible;"></span></p><p style="visibility: visible;"><span style="background-color: rgb(214, 214, 214); visibility: visible;">&nbsp;本文由宁波李惠利医院陆宏娜医师学习总结，</span></p><p style="visibility: visible;"><span style="background-color: rgb(214, 214, 214); visibility: visible;">&nbsp;感谢其整理及授权发表并与大家分享&nbsp;</span><br style="visibility: visible;"></p><ul style="list-style-type: square; visibility: visible;"><li style="visibility: visible;"><p style="margin: 0px; visibility: visible;"><span style="background-color: rgb(0, 0, 0); color: rgb(255, 255, 255); visibility: visible;">&nbsp;【</span><span style="text-align: justify; background-color: rgb(0, 0, 0); color: rgb(255, 255, 255); visibility: visible;">概念</span><span style="background-color: rgb(0, 0, 0); color: rgb(255, 255, 255); visibility: visible;">】&nbsp;</span></p></li></ul><p style="margin: 0px; line-height: 150%; visibility: visible;"><strong style="visibility: visible;">1.食管表浅癌</strong>就是局限于黏膜或黏膜下层，不管有无淋巴结转移。而我们常说的食管早癌其实是黏膜内癌，不管有没有淋巴结转移。下面这个表格方面我们记忆：</p><div cellspacing="0" style="visibility: visible;"><tbody style="visibility: visible;"><tr style="height: 41px; visibility: visible;"><td width="145" valign="top" style="padding: 0px 7px; border-width: 1px; border-color: rgb(146, 208, 80); background: rgb(197, 224, 179); visibility: visible;"><p style="margin: 0px; visibility: visible;"><span style="font-family: 宋体; font-size: 21px; visibility: visible;">T1a</span></p></td><td width="322" valign="top" style="padding: 0px 7px; border-left: none; border-right-width: 1px; border-right-color: rgb(146, 208, 80); border-top-width: 1px; border-top-color: rgb(146, 208, 80); border-bottom-width: 1px; border-bottom-color: rgb(146, 208, 80); visibility: visible;"><p style="margin: 0px; visibility: visible;"><span style="font-family: 宋体; font-size: 20px; visibility: visible;">EP，LPM，MM</span></p></td></tr><tr style="height: 41px; visibility: visible;"><td width="145" valign="top" style="padding: 0px 7px; border-left-width: 1px; border-left-color: rgb(146, 208, 80); border-right-width: 1px; border-right-color: rgb(146, 208, 80); border-top: none; border-bottom-width: 1px; border-bottom-color: rgb(146, 208, 80); background: rgb(197, 224, 179); visibility: visible;"><p style="margin: 0px; visibility: visible;"><span style="font-family: 宋体; font-size: 21px; visibility: visible;">T1b</span></p></td><td width="316" valign="top" style="padding: 0px 7px; border-left: none; border-right-width: 1px; border-right-color: rgb(146, 208, 80); border-top: none; border-bottom-width: 1px; border-bottom-color: rgb(146, 208, 80); visibility: visible;"><p style="margin: 0px; visibility: visible;"><span style="font-family: 宋体; font-size: 20px; visibility: visible;">SM</span></p></td></tr><tr style="height: 41px; visibility: visible;"><td width="145" valign="top" style="padding: 0px 7px; border-left-width: 1px; border-left-color: rgb(146, 208, 80); border-right-width: 1px; border-right-color: rgb(146, 208, 80); border-top: none; border-bottom-width: 1px; border-bottom-color: rgb(146, 208, 80); background: rgb(197, 224, 179); visibility: visible;"><p style="margin: 0px; visibility: visible;"><span style="font-family: 宋体; font-size: 21px; visibility: visible;">表浅癌</span></p></td><td width="322" valign="top" style="padding: 0px 7px; border-left: none; border-right-width: 1px; border-right-color: rgb(146, 208, 80); border-top: none; border-bottom-width: 1px; border-bottom-color: rgb(146, 208, 80); visibility: visible;"><p style="margin: 0px; visibility: visible;"><span style="font-family: 宋体; font-size: 20px; visibility: visible;">T1a+T1b</span></p></td></tr><tr style="height: 42px; visibility: visible;"><td width="145" valign="top" style="padding: 0px 7px; border-left-width: 1px; border-left-color: rgb(146, 208, 80); border-right-width: 1px; border-right-color: rgb(146, 208, 80); border-top: none; border-bottom-width: 1px; border-bottom-color: rgb(146, 208, 80); background: rgb(197, 224, 179); visibility: visible;"><p style="margin: 0px; visibility: visible;"><span style="font-family: 宋体; font-size: 21px; visibility: visible;">早期癌</span></p></td><td width="322" valign="top" style="padding: 0px 7px; border-left: none; border-right-width: 1px; border-right-color: rgb(146, 208, 80); border-top: none; border-bottom-width: 1px; border-bottom-color: rgb(146, 208, 80); visibility: visible;"><p style="margin: 0px; visibility: visible;"><span style="font-family: 宋体; font-size: 20px; visibility: visible;">T1a</span></p></td></tr></tbody></div><p style="margin: 0px; line-height: 150%; visibility: visible;"><strong style="visibility: visible;">2.&nbsp;原位癌</strong>&nbsp;M1＝EP，食管原位癌是日本的术语，欧美的诊断体系认为只有突破基底膜，出现间质浸润才算癌（浸润癌，但不是进展期癌，进展期癌是至少累及了固有肌层）。</p><p style="margin: 0px; line-height: 150%; visibility: visible;"><strong style="visibility: visible;">3.&nbsp;异型增生</strong>&nbsp;细胞学、组织结构上须存在异型性改变细胞学异常</p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; line-height: 150%; visibility: visible;"><span style="color: rgb(2, 30, 170); visibility: visible;">细胞学异常</span>：细胞核增大、深染、胞核大小不一、形态多样，核膜不规则，染色质分布不均匀，核浆比高，可见病理性核分裂像结构异常。</p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; line-height: 150%; visibility: visible;"><span style="color: rgb(122, 79, 214); visibility: visible;">组织学异常</span>：上皮层失去正常的层次结构，层次紊乱，细胞排列拥挤，失去正常排列极性(极性消失)。</p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; visibility: visible;"><strong style="visibility: visible;">欧美的诊断标准</strong><strong style="visibility: visible;"><span style="font-family: 宋体; visibility: visible;"><span style="visibility: visible;"></span></span></strong></p><div cellspacing="0" width="494" style="visibility: visible;"><tbody style="visibility: visible;"><tr style="height: 30px; visibility: visible;"><td width="128" valign="center" style="padding: 0px 7px; border-width: 1px; border-color: rgb(146, 208, 80); background: rgb(197, 224, 179); visibility: visible;"><p style="margin: 0px; text-align: center; visibility: visible;"><span style="font-family: 宋体; font-size: 16px; visibility: visible;">轻度异型增生</span></p></td><td width="220" valign="center" style="padding: 0px 7px; border-left: none; border-right-width: 1px; border-right-color: rgb(146, 208, 80); border-top-width: 1px; border-top-color: rgb(146, 208, 80); border-bottom-width: 1px; border-bottom-color: rgb(146, 208, 80); visibility: visible;"><p style="margin: 0px; visibility: visible;"><span style="font-family: 宋体; font-size: 16px; visibility: visible;">累及上皮层1/3</span></p></td><td width="146" valign="center" rowspan="2" style="padding: 0px 7px; border-left: none; border-right-width: 1px; border-right-color: rgb(146, 208, 80); border-top-width: 1px; border-top-color: rgb(146, 208, 80); border-bottom-width: 1px; border-bottom-color: windowtext; visibility: visible;"><p style="margin: 0px; text-align: center; visibility: visible;"><span style="font-family: 宋体; font-size: 16px; visibility: visible;">低级别上皮内瘤变</span></p></td></tr><tr style="height: 31px; visibility: visible;"><td width="128" valign="center" style="padding: 0px 7px; border-left-width: 1px; border-left-color: rgb(146, 208, 80); border-right-width: 1px; border-right-color: rgb(146, 208, 80); border-top: none; border-bottom-width: 1px; border-bottom-color: rgb(146, 208, 80); background: rgb(197, 224, 179); visibility: visible;"><p style="margin: 0px; text-align: center; visibility: visible;"><span style="font-family: 宋体; font-size: 16px; visibility: visible;">中度异型增生</span></p></td><td width="220" valign="center" style="padding: 0px 7px; border-left: none; border-right-width: 1px; border-right-color: rgb(146, 208, 80); border-top: none; border-bottom-width: 1px; border-bottom-color: rgb(146, 208, 80); visibility: visible;"><p style="margin: 0px; visibility: visible;"><span style="font-family: 宋体; font-size: 16px; visibility: visible;">累及上皮层1/3-2/3</span></p></td></tr><tr style="height: 28px; visibility: visible;"><td width="128" valign="center" style="padding: 0px 7px; border-left-width: 1px; border-left-color: rgb(146, 208, 80); border-right-width: 1px; border-right-color: rgb(146, 208, 80); border-top: none; border-bottom-width: 1px; border-bottom-color: rgb(146, 208, 80); background: rgb(197, 224, 179); visibility: visible;"><p style="margin: 0px; text-align: center; visibility: visible;"><span style="font-family: 宋体; font-size: 16px; visibility: visible;">重度异型增生</span></p></td><td width="220" valign="center" style="padding: 0px 7px; border-left: none; border-right-width: 1px; border-right-color: rgb(146, 208, 80); border-top: none; border-bottom-width: 1px; border-bottom-color: rgb(146, 208, 80); visibility: visible;"><p style="margin: 0px; visibility: visible;"><span style="font-family: 宋体; font-size: 16px; visibility: visible;">累及上皮层2/3</span></p></td><td width="146" valign="center" rowspan="2" style="padding: 0px 7px; border-left: none; border-right-width: 1px; border-right-color: rgb(146, 208, 80); border-top: none; border-bottom-width: 1px; border-bottom-color: windowtext; visibility: visible;"><p style="margin: 0px; text-align: center; visibility: visible;"><span style="font-family: 宋体; font-size: 16px; visibility: visible;">高级别上皮内瘤变</span></p></td></tr><tr style="height: 25px; visibility: visible;"><td width="128" valign="center" style="padding: 0px 7px; border-left-width: 1px; border-left-color: rgb(146, 208, 80); border-right-width: 1px; border-right-color: rgb(146, 208, 80); border-top: none; border-bottom-width: 1px; border-bottom-color: rgb(146, 208, 80); background: rgb(197, 224, 179); visibility: visible;"><p style="margin: 0px; text-align: center; visibility: visible;"><span style="font-family: 宋体; font-size: 16px; visibility: visible;">原位癌</span></p></td><td width="220" valign="center" style="padding: 0px 7px; border-left: none; border-right-width: 1px; border-right-color: rgb(146, 208, 80); border-top: none; border-bottom-width: 1px; border-bottom-color: rgb(146, 208, 80); visibility: visible;"><p style="margin: 0px; visibility: visible;"><span style="font-family: 宋体; font-size: 16px; visibility: visible;">累及上皮层全层</span></p></td></tr><tr style="height:26px;"><td width="128" valign="center" style="padding: 0px 7px;border-left-width: 1px;border-left-color: rgb(146, 208, 80);border-right-width: 1px;border-right-color: rgb(146, 208, 80);border-top: none;border-bottom-width: 1px;border-bottom-color: rgb(146, 208, 80);background: rgb(197, 224, 179);"><p style="margin-top:0;margin-right:0;margin-bottom:0;margin-left:0;text-align:center;"><span style="font-family: 宋体; font-size: 16px;">浸润癌</span></p></td><td width="220" valign="center" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: rgb(146, 208, 80);border-top: none;border-bottom-width: 1px;border-bottom-color: rgb(146, 208, 80);"><p style="margin: 0px;"><span style="font-family: 宋体; font-size: 16px;">突破基底膜</span></p></td><td width="146" valign="center" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: rgb(146, 208, 80);border-top: none;border-bottom-width: 1px;border-bottom-color: rgb(146, 208, 80);"><br></td></tr></tbody></div><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_1_.jpeg' data-backh="179" data-backw="277" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwS6KLakwEFPJfjXJxBoVicmBQZbib8cEfX0iaZH9Ss45WmdX82R0YA9bkVQ/0?wx_fmt=png" data-oversubscription-url="http://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_jpg/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSvTgdRelTBAKmASNa04mLwdp1icuTW2vKBoMkSwS3iaLLazJgjCINqxlg/0?wx_fmt=jpeg" data-ratio="0.15884" data-s="300,640" data-type="jpeg" data-w="277" style="text-align: center; width: 677px !important; height: auto !important; visibility: visible !important;" data-original-style="text-align: center;width: 100%;" data-index="1" src="http://image109.360doc.com/DownloadImg/2024/11/0316/_1_.jpeg" _width="100%" alt="图片" data-fail="0"></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_2_.jpeg' data-backh="180" data-backw="266" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSOLj0YbQDiaxjtv6rJw6OZb5u8vFlb6Q5iaZ1npCJLiaKcCMibiaqgX5iaL3g/0?wx_fmt=png" data-oversubscription-url="http://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_jpg/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSUSe9VzAgEGNXxcz2D2t0Gp44tvcnOzd2dxtR4ImEZ8WrZm8iaHOCYew/0?wx_fmt=jpeg" data-ratio="0.33082" data-s="300,640" data-type="jpeg" data-w="266" style="width: 677px !important; height: auto !important; visibility: visible !important;" data-original-style="width: 100%;height: auto;" data-index="2" src="http://image109.360doc.com/DownloadImg/2024/11/0316/_2_.jpeg" _width="100%" alt="图片" data-fail="0"></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_3_.jpeg' data-backh="172" data-backw="282" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSVuVUS0jT806nLNtPNicaW0RhQ0YfAf2sXsO89vtuKQMxgaxHGAicdJicg/0?wx_fmt=png" data-oversubscription-url="http://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_jpg/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSfRlkuoFicKp2roP3e2doFcqL8NfLTLKPCOfpq3xZcfxufajMMiaalj1A/0?wx_fmt=jpeg" data-ratio="0.41844" data-s="300,640" data-type="jpeg" data-w="282" style="width: 677px !important; height: auto !important; visibility: visible !important;" data-original-style="width: 100%;height: auto;" data-index="3" src="http://image109.360doc.com/DownloadImg/2024/11/0316/_3_.jpeg" _width="100%" alt="图片" data-fail="0"></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_4_.jpeg' data-backh="191" data-backw="257" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwS07Xnfz1L48n7UpxvwUkxI4eHwmYhNrPOlgDd7jy0fCdF3ejsE2Pm6g/0?wx_fmt=png" data-oversubscription-url="http://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_jpg/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwS7FNmPNw1a4ClqbCYwYiaFzr7HZMySoX1nEH3U23QlR17NNyAXbxePow/0?wx_fmt=jpeg" data-ratio="0.85992" data-s="300,640" data-type="jpeg" data-w="257" style="width: 677px !important; height: auto !important; visibility: visible !important;" data-original-style="width: 100%;height: auto;" data-index="4" src="http://image109.360doc.com/DownloadImg/2024/11/0316/_4_.jpeg" _width="100%" alt="图片" data-fail="0"></p><p style="text-align: right;"><em><span style="text-decoration-line: underline;">（雨夜 de小筑&nbsp;）</span></em><span style="text-decoration-line: underline;"></span><span style="text-decoration-line: underline;"></span></p><p><strong>4.食管鳞癌的浸润深度</strong></p><p style="line-height: 150%;">M1＝局限于上皮层（EP），原位癌</p><p style="line-height: 150%;">M2＝侵犯至黏膜固有层（LMP）</p><p style="line-height: 150%;">M3＝侵犯至黏膜肌层（MM）</p><p style="line-height: 150%;">SM1＝侵犯至黏膜下层小于200um</p><p style="line-height: 150%;">SM2＝侵犯至黏膜下层中层</p><p style="line-height: 150%;">SM3＝侵犯至黏膜下层下层<span style="font-family: 宋体; line-height: 150%; font-size: 16px;"></span></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_5_.jpeg' data-backh="438" data-backw="553" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSsqAk04e9yqUhGgTY9u2VwEwDicdMskFia444dRKXgcdNFJgPUibeiceY9A/0?wx_fmt=png" data-ratio="0.83364" data-s="300,640" data-type="png" data-w="553" style="width: 677px !important; height: auto !important; visibility: visible !important;" data-original-style="width: 100%;height: auto;" data-index="5" src="http://image109.360doc.com/DownloadImg/2024/11/0316/_5_.jpeg" _width="100%" alt="图片" data-fail="0"></p><p style="text-align: right;"><em><span style="text-decoration-line: underline;">&nbsp;小山恒男《ESDのための食道癌術前診断》</span></em><span style="text-decoration-line: underline;"></span></p><p style="margin: 0px; line-height: 150%;"><strong>5.食管鳞癌的分化</strong></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; line-height: 150%;">鳞癌的分化是用癌细胞的角化程度进行评估，如果角化物含量占肿瘤组织的3/4或以上，则为高分化鳞癌；角化物含量少于1/4，则为低分化鳞癌；中分化鳞癌的角化物含量介于两者之间。<span style="font-family: 宋体; line-height: 150%; letter-spacing: 1px; font-size: 16px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;"></span></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; line-height: 150%;"><span style="background-color: rgb(122, 79, 214);color: rgb(255, 255, 255);">▼高分化&nbsp;</span><br></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_6_.jpeg' data-backh="225" data-backw="262" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSKAos9NibHONwIjDxOUS38m30JbSqmmNEMic0P0xzlgCNelUUfibclYomg/0?wx_fmt=png" data-oversubscription-url="http://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_jpg/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSzbib1RGXScoZjUxCUMGrGnlnJQvxqgTAblX0ibxqLv4HXElJjt0lzNYQ/0?wx_fmt=jpeg" data-ratio="0.41985" data-s="300,640" data-type="jpeg" data-w="262" style="width: 677px !important; height: auto !important; visibility: visible !important;" data-original-style="width: 100%;height: auto;" data-index="6" src="http://image109.360doc.com/DownloadImg/2024/11/0316/_6_.jpeg" _width="100%" alt="图片" data-fail="0"></p><p><span style="background-color: rgb(122, 79, 214);color: rgb(255, 255, 255);">▼低分化&nbsp;</span><br></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_7_62665.jpeg' data-backh="225" data-backw="290" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwScOfAAPu2SibEtozzzbl9DDlhibRhFIQetkZxATyeZ7Xe0PgqL61g6micg/0?wx_fmt=png" data-oversubscription-url="http://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_jpg/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSgjDMpc5HBniadTvXFKtYO243L9LV3ibWicZpGgTBUK95Mox5SXJI2M2sQ/0?wx_fmt=jpeg" data-ratio="0.55172" data-s="300,640" data-type="jpeg" data-w="290" style="width: 677px !important; height: auto !important; visibility: visible !important;" data-original-style="width: 100%;height: auto;" data-index="7" src="http://image109.360doc.com/DownloadImg/2024/11/0316/_7_62665.jpeg" _width="100%" alt="图片" data-fail="0"></p><p style="margin: 0px;text-align: right;line-height: 150%;"><span style="text-decoration-line: underline;"><em>（雨夜&nbsp;de小筑&nbsp;）</em></span><span style="text-decoration-line: underline;"></span></p><ul style="list-style-type: square;"><li><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px;"><span style="background-color: rgb(0, 0, 0);color: rgb(255, 255, 255);">&nbsp;【食管的基本构造】&nbsp;</span><span style="background-color: rgb(0, 0, 0);color: rgb(255, 255, 255);"></span></p></li></ul><p style="margin: 0px; line-height: 150%;">食管从腔面向腔外按层次划分为黏膜层、黏膜下层、固有肌层和外膜。其中黏膜层包括上皮层，固有层和黏膜肌层。<span style="font-family: 宋体; line-height: 150%; letter-spacing: 1px; font-size: 16px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;"></span></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_8_.jpeg' data-backh="314" data-backw="465" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSJZDicLEQcdtQU0OWZesEXubyLaJGZ8Qmcwo1HiaibwhBxDMe97dmP3ibAA/0?wx_fmt=png" data-oversubscription-url="http://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_jpg/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSpZtvaydDfdwbQ1ANWuqF7rICpAZHKiaiaMWhIM9bfnoxgwZ9ibBKAcKJg/0?wx_fmt=jpeg" data-ratio="0.43011" data-s="300,640" data-type="jpeg" data-w="465" style="max-width: 650px;" data-original-style="width: 100%;height: auto;" data-index="8" src="http://image109.360doc.com/DownloadImg/2024/11/0316/_8_.jpeg" _width="100%" alt="图片" data-fail="0"></p><p style="margin: 0px;text-align: right;line-height: 150%;"><span style="text-decoration-line: underline;"><em>小山恒男《ESDのための食道癌術前診断》</em></span></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_9_.jpeg' data-backh="426" data-backw="417" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwS7QrUoShhKiaWffe0OUmyhhORSk6qSdgd7NibqPqZZaeNP09tVSUHl6hg/0?wx_fmt=png" data-oversubscription-url="http://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_jpg/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSUiaxmCcSPsCccTNh8uib0RMTLRwmiac2ITyBrgWlsBVTs12mvUTs5dSVw/0?wx_fmt=jpeg" data-ratio="1.09497" data-s="300,640" data-type="jpeg" data-w="417" style="max-width: 650px;" data-original-style="width: 100%;height: auto;" data-index="9" src="http://image109.360doc.com/DownloadImg/2024/11/0316/_9_.jpeg" _width="100%" alt="图片" data-fail="0"></p><p style="text-align: right;"><span style="text-decoration-line: underline;"><em>（雨夜&nbsp;de小筑&nbsp;）</em></span><span style="text-decoration-line: underline;"></span></p><p style="line-height: 150%;">上图我们可以看到食管扁平上皮内有乳头状结构，乳头内的微血管就叫上皮乳头内毛细血管袢（intra-epithelial papillary capillary loop ; IPCL）。我们通过放大内镜对IPCL的观察，可以初步在镜下判断食管病变的性质，范围，深度等方面。<span style="font-family: 宋体; line-height: 150%; letter-spacing: 1px; font-size: 16px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;"></span></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_10_.jpeg' data-backh="413" data-backw="553" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSeeYeSBw2uRcLy8B2sZN7zkO0n1AYjHx2tPicOz2q2d6Xodk5K4gw0LQ/0?wx_fmt=png" data-oversubscription-url="http://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_jpg/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSC1r5XGrKxtYhqeRsD0k9SpUA2fSlHY3gTp2EGNZSzMdweO4XQBCLhw/0?wx_fmt=jpeg" data-ratio="0.79747" data-s="300,640" data-type="jpeg" data-w="553" style="max-width: 650px;" data-original-style="width: 100%;height: auto;" data-index="10" src="http://image109.360doc.com/DownloadImg/2024/11/0316/_10_.jpeg" _width="100%" alt="图片" data-fail="0"></p><p style="text-align: right;"><span style="text-decoration-line: underline;"><em>（ 扫地僧一听）</em></span><span style="font-family: 宋体;"></span></p><p>放大内镜看到的血管基本都位于固有层，按位置可以划为三层，第一层位于固有层最顶端，也就是乳头内的毛细血管袢（IPCL），第二层位于固有层浅层，基底膜的下方，叫做上皮下微血管网（SECN），第三层位于固有层较深的区域，叫做树枝状血管网。<span style="font-family: 宋体; letter-spacing: 1px; font-size: 16px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;"></span></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_11_.png' data-backh="306" data-backw="554" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwShMJibfdVluQJId0jx7sz2vgiahykfpOyVZSOiaYH7UM7rGQn1Picctw3VA/0?wx_fmt=png" data-ratio="0.71119" data-s="300,640" data-type="png" data-w="554" style="width: 677px !important; height: auto !important; visibility: visible !important;" data-original-style="width: 100%;height: auto;" data-index="11" src="http://pubimage.360doc.com/wz/default.gif" _width="100%" alt="图片" data-fail="0"></p><p style="text-align: right;"><em><span style="text-decoration-line: underline; font-size: 17px;">池田 晴夫，日本食道学会拡大内視鏡分類と深達度深達度診断における B3 血管の意義</span></em><span style="text-decoration-line: underline; font-size: 17px;"></span><span style="text-decoration-line: underline;"></span></p><ul style="list-style-type: square;"><li><p><span style="background-color: rgb(0, 0, 0);color: rgb(255, 255, 255);">&nbsp;【AB分型及浸润深度的判断&nbsp;】&nbsp;</span></p></li></ul><p style="line-height: 150%;">对于IPCL的研究，有井上分型、有马分型、AB分型，这些分型都是观察食管IPCL的。2011年日本食管学会提出的AB分型是综合了井上及有马分型，并借鉴了有马分型里的AVA的概念及R型血管的概念。AB分型最大的优势是一种基于偏向治疗原则的分型方法。良性病变不需处理的都归为A型，内镜治疗的绝对适应症都归为B1型，内镜治疗的相对适应症归为B2型，外科适应症归为B3型。<span style="font-family: 宋体; line-height: 150%; letter-spacing: 1px; font-size: 16px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;"></span></p><div cellspacing="0" width="568"><tbody><tr><td width="189" valign="top" style="padding: 0px 7px;border-width: 1px;border-color: windowtext;background: rgb(189, 214, 238);"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background: rgb(255, 255, 255);">分型</span></p></td><td width="177" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top-width: 1px;border-top-color: windowtext;border-bottom-width: 1px;border-bottom-color: windowtext;background: rgb(189, 214, 238);"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background: rgb(255, 255, 255);">所见</span></p></td><td width="202" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top-width: 1px;border-top-color: windowtext;border-bottom-width: 1px;border-bottom-color: windowtext;background: rgb(189, 214, 238);"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background: rgb(255, 255, 255);">浸润深度</span></p></td></tr><tr><td width="189" valign="top" style="padding: 0px 7px;border-left-width: 1px;border-left-color: windowtext;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">A</span></p></td><td width="177" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">IPCL没有变化或有轻微变化</span></p></td><td width="202" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">IN</span></p></td></tr><tr><td width="189" valign="top" style="padding: 0px 7px;border-left-width: 1px;border-left-color: windowtext;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">B1</span></p></td><td width="177" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">扩张、蛇形弯曲、口径大小不一、形状不规则的形成回路的异常血管</span></p></td><td width="202" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">T1a-EP/T1a-LPM</span></p></td></tr><tr><td width="189" valign="top" style="padding: 0px 7px;border-left-width: 1px;border-left-color: windowtext;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">B2</span></p></td><td width="177" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">不形成回路的异常血管</span></p></td><td width="202" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">T1a-MM/T1b-SM1</span></p></td></tr><tr><td width="189" valign="top" style="padding: 0px 7px;border-left-width: 1px;border-left-color: windowtext;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">B3</span></p></td><td width="177" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">高度扩张增粗不规则的血管（约是B2血管的3倍以上，血管直径超过60um）</span></p></td><td width="202" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">T1b-SM2以深</span></p></td></tr><tr><td width="189" valign="top" style="padding: 0px 7px;border-left-width: 1px;border-left-color: windowtext;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;background: rgb(255, 229, 153);"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background: rgb(255, 255, 255);">AVA（B2/B3血管）</span></p></td><td width="177" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;background: rgb(255, 229, 153);"><br></td><td width="202" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;background: rgb(255, 229, 153);"><br></td></tr><tr><td width="189" valign="top" style="padding: 0px 7px;border-left-width: 1px;border-left-color: windowtext;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">AVA-small</span></p></td><td width="177" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">0.5mm以下</span></p></td><td width="202" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">T1a-EP/T1a-LPM</span></p></td></tr><tr><td width="189" valign="top" style="padding: 0px 7px;border-left-width: 1px;border-left-color: windowtext;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">AVA-middle</span></p></td><td width="177" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">0.5mm-3mm</span></p></td><td width="202" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">T1a-MM/T1b-SM1</span></p></td></tr><tr><td width="189" valign="top" style="padding: 0px 7px;border-left-width: 1px;border-left-color: windowtext;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">AVA-large</span></p></td><td width="177" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">3mm以上</span></p></td><td width="202" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">T1b-SM2以深</span></p></td></tr><tr><td width="568" valign="top" colspan="3" style="padding: 0px 7px;border-left-width: 1px;border-left-color: windowtext;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">注：仅由B1血管构成的AVA，无论范围多大，都视为浸润深度T1a-EP/T1a-LPM</span></p></td></tr><tr><td width="189" valign="top" style="padding: 0px 7px;border-left-width: 1px;border-left-color: windowtext;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;background: rgb(226, 239, 218);"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background: rgb(255, 255, 255);">R型血管</span></p></td><td width="177" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top-width: 1px;border-top-color: windowtext;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">不规则的细网状血管</span></p></td><td width="202" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top-width: 1px;border-top-color: windowtext;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">低分化鳞癌/INFc/特殊型的肿瘤</span></p></td></tr><tr><td width="189" valign="top" style="padding: 0px 7px;border-left-width: 1px;border-left-color: windowtext;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;background: rgb(226, 239, 218);"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background: rgb(255, 255, 255);">B2i型血管</span></p></td><td width="177" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">管径较细，密度较高，不伴有口径不一</span></p></td><td width="202" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">对浸润深度意义不大，不要判断过深</span></p></td></tr><tr><td width="189" valign="top" style="padding: 0px 7px;border-left-width: 1px;border-left-color: windowtext;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;background: rgb(226, 239, 218);"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background: rgb(255, 255, 255);">BC(background coloration)</span></p></td><td width="177" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><p><span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">NBI下褐色的背景色</span></p></td><td width="202" valign="top" style="padding: 0px 7px;border-left: none;border-right-width: 1px;border-right-color: windowtext;border-top: none;border-bottom-width: 1px;border-bottom-color: windowtext;"><br></td></tr></tbody></div><ul style="list-style-type: disc;"><li><p>Type A型血管▼</p></li></ul><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_12_.jpeg' data-ratio="0.00483" data-s="300,640" data-type="png" data-w="828" style="max-width: 650px;" data-original-style="" data-index="12" src="http://pubimage.360doc.com/wz/default.gif" _width="677px" alt="图片" data-fail="0"></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_13_.jpeg' data-ratio="0." data-s="300,640" data-type="png" data-w="823" style="max-width: 650px;" data-original-style="" data-index="13" src="http://pubimage.360doc.com/wz/default.gif" _width="677px" alt="图片" data-fail="0"></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_14_.jpeg' data-ratio="0.4686" data-s="300,640" data-type="png" data-w="828" style="max-width: 650px;" data-original-style="" data-index="14" src="http://pubimage.360doc.com/wz/default.gif" _width="677px" alt="图片" data-fail="0"></p><ul style="list-style-type: disc;"><li><p>Type B1型血管▼</p></li></ul><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_15_.jpeg' data-backh="240" data-backw="554" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwShRjfw8FmlEWZXPWu2Diafibsv3eHvA0NZPfW8qIqbmNXIibWYZljGLmEQ/0?wx_fmt=png" data-oversubscription-url="http://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_jpg/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSZWNGDfZu95X7Pqv3XGTxtKlteqPhEbMdHYR0WYEllVKVAJ9vuCMiczg/0?wx_fmt=jpeg" data-ratio="0.98917" data-s="300,640" data-type="jpeg" data-w="554" style="max-width: 650px;" data-original-style="width: 100%;height: auto;" data-index="15" src="http://pubimage.360doc.com/wz/default.gif" _width="100%" alt="图片" data-fail="0"></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_16_.jpeg' data-ratio="0." data-s="300,640" data-type="png" data-w="817" style="max-width: 650px;" data-original-style="" data-index="16" src="http://pubimage.360doc.com/wz/default.gif" _width="677px" alt="图片" data-fail="0"></p><p style="text-align: right;">&nbsp;pT1a-LPM<span style="font-family: 宋体; letter-spacing: 1px; font-size: 17px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;"></span></p><ul style="list-style-type: disc;"><li><p>Type B2型血管▼</p></li></ul><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_17_.jpeg' data-backh="239" data-backw="554" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSTkhFKJe6l3mn8uJ9FdB0kj8Qcll3ZoLPRzLo6H0N9ZHzXPMx1YGpCA/0?wx_fmt=png" data-oversubscription-url="http://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_jpg/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSB6DOI78KAA7FERALMia4YTCNZxuVlBXdpHnwYDrGDmGGSCrDPEMBEoQ/0?wx_fmt=jpeg" data-ratio="0.82672" data-s="300,640" data-type="jpeg" data-w="554" style="max-width: 650px;" data-original-style="width: 100%;height: auto;" data-index="17" src="http://pubimage.360doc.com/wz/default.gif" _width="100%" alt="图片" data-fail="0"></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_18_.jpeg' data-ratio="0." data-s="300,640" data-type="png" data-w="825" style="max-width: 650px;" data-original-style="" data-index="18" src="http://pubimage.360doc.com/wz/default.gif" _width="677px" alt="图片" data-fail="0"></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_19_62997.jpeg' data-ratio="0.9694" data-s="300,640" data-type="png" data-w="817" style="max-width: 650px;" data-original-style="" data-index="19" src="http://pubimage.360doc.com/wz/default.gif" _width="677px" alt="图片" data-fail="0"></p><p style="text-align: right;">pT1a-MM<span style="font-family: 宋体; letter-spacing: 1px; font-size: 17px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;"></span></p><ul style="list-style-type: disc;"><li><p>Type B3型血管▼</p></li></ul><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_20_.jpeg' data-ratio="0." data-s="300,640" data-type="png" data-w="824" style="max-width: 650px;" data-original-style="" data-index="20" src="http://pubimage.360doc.com/wz/default.gif" _width="677px" alt="图片" data-fail="0"></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_21_.jpeg' data-ratio="0.04932" data-s="300,640" data-type="png" data-w="811" style="max-width: 650px;" data-original-style="" data-index="21" src="http://pubimage.360doc.com/wz/default.gif" _width="677px" alt="图片" data-fail="0"></p><p style="text-align: right;">&nbsp;T1b-SM2<span style="font-family: 宋体; font-size: 20px;"></span></p><p><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_22_.jpeg' data-backh="236" data-backw="553" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSy3yuRos7SCluoPPGkJM7GMz30x140JicPZG5GoKs3G7AMlte6dPPiaeQ/0?wx_fmt=png" data-oversubscription-url="http://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_jpg/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwScrScDGp1TzEmIiabbS0fib2r9chH5BzDfKWKTQMR7G7ERMuesnT69ebA/0?wx_fmt=jpeg" data-ratio="0.74141" data-s="300,640" data-type="jpeg" data-w="553" style="max-width: 650px;" data-original-style="width: 100%;height: auto;" data-index="22" src="http://pubimage.360doc.com/wz/default.gif" _width="100%" alt="图片" data-fail="0"><span style="text-indent: 79px;">▲癌病灶边缘隆起部的B3血管，末梢向B2血管移行(黄圈内)</span></p><ul style="list-style-type: disc;"><li><p>AVA▼<strong><span style="font-family: 宋体; font-size: 19px;"></span></strong></p></li></ul><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_23_.jpeg' data-backh="159" data-backw="553" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSm5JunTnXeKhZ5W4HJ8agExG1tDdsAqE1JibJv9aLg8d09qHhAYwTh8A/0?wx_fmt=png" data-oversubscription-url="http://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_jpg/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSvC7G4Gqf4Kr5886RJP3V0vl4biaDc1VVeOibibwRiakfxmJYklKumeo9sQ/0?wx_fmt=jpeg" data-ratio="0.83002" data-s="300,640" data-type="jpeg" data-w="553" style="max-width: 650px;" data-original-style="width: 100%;height: auto;" data-index="23" src="http://pubimage.360doc.com/wz/default.gif" _width="100%" alt="图片" data-fail="0"></p><p style="text-align: center;">AVA-small&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; AVA-middle&nbsp; &nbsp; &nbsp;&nbsp;&nbsp; AVA-large<span style="font-family: 宋体; letter-spacing: 1px; font-size: 12px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;"></span></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_24_63081.jpeg' data-backh="254" data-backw="275" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSKCjVFbR1BIwY8wVicVKZBE7TugGoMjiceUV6ickicaibCTzfQSfvwXRmvyA/0?wx_fmt=png" data-oversubscription-url="http://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_jpg/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSqtxmAZPX0sfMia6y3Vv2dzrXVib1tntvhpeyfcTnWhcQFFE196JC2NDA/0?wx_fmt=jpeg" data-ratio="0.63636" data-s="300,640" data-type="jpeg" data-w="275" style="width: 677px !important; height: auto !important; visibility: visible !important;" data-original-style="width: 100%;height: auto;" data-index="24" src="http://pubimage.360doc.com/wz/default.gif" _width="100%" alt="图片" data-fail="0"></p><p>▲仅由B1血管构成的AVA，无论范围多大，都视为浸润深度T1a-EP/T1a-LPM</p><ul style="list-style-type: disc;"><li><p>B2i型血管▼<strong><span style="font-family: 宋体; font-size: 19px;"></span></strong></p></li></ul><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_25_.jpeg' data-ratio="0.83951" data-s="300,640" data-type="png" data-w="810" style="max-width: 650px;" data-original-style="" data-index="25" src="http://pubimage.360doc.com/wz/default.gif" _width="677px" alt="图片" data-fail="0"></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_26_.jpeg' data-ratio="0.02781" data-s="300,640" data-type="png" data-w="827" style="max-width: 650px;" data-original-style="" data-index="26" src="http://pubimage.360doc.com/wz/default.gif" _width="677px" alt="图片" data-fail="0"></p><ul style="list-style-type: disc;"><li><p>R型血管▼</p></li></ul><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_27_.jpeg' data-ratio="0." data-s="300,640" data-type="png" data-w="819" style="max-width: 650px;" data-original-style="" data-index="27" src="http://pubimage.360doc.com/wz/default.gif" _width="677px" alt="图片" data-fail="0"></p><p><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_28_.jpeg' data-ratio="0." data-s="300,640" data-type="png" data-w="822" style="max-width: 650px;" data-original-style="" data-index="28" src="http://pubimage.360doc.com/wz/default.gif" _width="677px" alt="图片" data-fail="0"><span style="color: rgb(255, 255, 255); background-color: rgb(121, 123, 170);">&nbsp;Type B2i和Type R血管都是非攀状血管，但是伴随炎症的Type B2i密度高，不伴有口径不一，这是两者的鉴别点。</span></p><p style="margin-bottom: 16px; line-height: 25.5px;">关于R血管详细的链接内容请点击：</p><p style="margin-bottom: 16px; line-height: 25.5px;">医学美图：食管“R”型血管<br></p><p><span style="text-indent: 32px;">一些研究报告显示B1血管提示肿瘤浸润深度为T1a-EP/T1a-LPM的敏感性和阳性预测值（PPV）分别为91.7-97.5%和88.5-92.4%，B3血管预测T1b-SM2以深的敏感性和PPV分别是55.0%和100%，相比之下，对于B2血管预测T1a-MM/T1b-SM1的敏感性和PPV分别为75-86%和53-75%，虽然B1型和B3型的PPV值较高，但B2型的PPV值较低。</span><span style="text-indent: 32px;">因此有些研究对B2血管的进行了进一步的亚分型来提高B2血管对食管癌浸润深度的判断准确率。</span></p><p><span style="text-indent: 32px;">平澤大等人以2012年1月～2016年10月在本院进行了ESD的食道SCC133例152病变为对象。</span><span style="text-indent: 32px;">回顾性地研究了JESTypeB2的病变，将TypeB2分为以下四种亚型：</span></p><p style="margin-top:0;margin-right:0;margin-bottom:0;margin-left:0;text-autospace:ideograph-numeric;line-height:150%;"><span style="color: rgb(255, 255, 255); background-color: rgb(217, 33, 66);">&nbsp;1.</span><span style="color: rgb(255, 255, 255);">&nbsp;</span><span style="color: rgb(255, 255, 255); background-color: rgb(122, 79, 214);">&nbsp;</span><span style="background-color: rgb(122, 79, 214); color: rgb(255, 255, 255);">B2-AVA</span>：包围AVA(Avascular Area)的非环形血管，浸润深度取决于AVA的大小。仅由B1血管构成的AVA，无论范围多大，都视为浸润深度T1a-EP/T1a-LPM。</p><p style="text-autospace:ideograph-numeric;line-height:150%;"><span style="color: rgb(255, 255, 255); background-color: rgb(217, 33, 66);">&nbsp;2.</span><span style="color: rgb(255, 255, 255);">&nbsp;</span><span style="color: rgb(255, 255, 255); background-color: rgb(122, 79, 214);">&nbsp;</span><span style="background-color: rgb(122, 79, 214); color: rgb(255, 255, 255);">B2-Inflamation</span>：在癌区域内的糜烂或再生粘膜周围发现的非环状血管。（小山恒男教授将其定义为一种管径较细，密度较高，不伴有口径不一的除外“B2 pure”的B2型血管的亚型）</p><p style="text-autospace:ideograph-numeric;line-height:150%;"><span style="color: rgb(255, 255, 255); background-color: rgb(217, 33, 66);">&nbsp;3.</span><span style="color: rgb(255, 255, 255);">&nbsp;</span><span style="color: rgb(255, 255, 255); background-color: rgb(122, 79, 214);">&nbsp;</span><span style="background-color: rgb(122, 79, 214); color: rgb(255, 255, 255);">B2-Narrow</span>：B2-Inflammation，B2-AVA以外的非环状血管，其区域长径小于4mm</p><p style="text-autospace:ideograph-numeric;line-height:150%;"><span style="color: rgb(255, 255, 255); background-color: rgb(217, 33, 66);">&nbsp;4.</span><span style="color: rgb(255, 255, 255);">&nbsp;</span><span style="color: rgb(255, 255, 255); background-color: rgb(122, 79, 214);">&nbsp;</span><span style="background-color: rgb(122, 79, 214); color: rgb(255, 255, 255);">B2-Broad</span>：B2-Inflammation，B2-AVA以外的非环状血管，其区域长径大于4mm</p><p style="text-autospace:ideograph-numeric;line-height:150%;">如一个病变内存在多处关注区域的情况，按照B2-Broad&gt;B2-Narrow&gt;B2-Inflammation&gt;B2-AVA的顺序优先。</p><p>Type B2血管仅Broad作为T1a-MM以深的指标是有用的，在这种情况下的正确诊断率改善到了91．4％，PPV改善到了70．6％。<span style="font-family: 宋体; font-size: 16px;"></span></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_29_63150.jpeg' data-backh="482" data-backw="554" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSBH9rw1vBbJ9yLn3BNkmuXMRCSwerLN8BCaaw9lkQm0HKXrSbpDqjicA/0?wx_fmt=png" data-ratio="0.30325" data-s="300,640" data-type="png" data-w="554" style="width: 677px !important; height: auto !important; visibility: visible !important;" data-original-style="width: 100%;height: auto;" data-index="29" src="http://pubimage.360doc.com/wz/default.gif" _width="100%" alt="图片" data-fail="0"></p><p>▲B2-Narrow病例（JES Type B2区域长径约为2 mm），病理提示SCC浸润T1a-LPM<span style="font-family: 宋体; letter-spacing: 1px; font-size: 15px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;"></span></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_30_.jpeg' data-backh="240" data-backw="554" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSAve7wsOoLlEODac2fkbvSFfjP3NylwgBH3UEcYeibc9bQlvkcULOxZA/0?wx_fmt=png" data-oversubscription-url="http://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_jpg/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSmbjKibMqvzdsUHmehH8IqfmhjvHvkQlQmrsfvhpqBEqic5XLzMtiaybUg/0?wx_fmt=jpeg" data-ratio="0.98917" data-s="300,640" data-type="jpeg" data-w="554" style="max-width: 650px;" data-original-style="width: 100%;height: auto;" data-index="30" src="http://pubimage.360doc.com/wz/default.gif" _width="100%" alt="图片" data-fail="0"></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_31_.jpeg' data-backh="296" data-backw="393" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSPKggxuoPSgWMkaUrpdvSibrlwR8z05OiaibrpbhJO9FWGcOdFiazxFs8Pg/0?wx_fmt=png" data-oversubscription-url="http://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_jpg/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSbZpgDPGEFFL2CNOuP9DuucvZLuoIbg0xE2ia7ibIibB09jibGvqVTFrzqA/0?wx_fmt=jpeg" data-ratio="0.76081" data-s="300,640" data-type="jpeg" data-w="393" style="max-width: 650px;" data-original-style="width: 100%;height: auto;" data-index="31" src="http://pubimage.360doc.com/wz/default.gif" _width="100%" alt="图片" data-fail="0"></p><p style="text-autospace:ideograph-numeric;line-height:150%;">▲B2-Broad病例（JES Type B2区域长径约为12 mm），病理提示SCC浸润T1a-MM。</p><p style="text-autospace:ideograph-numeric;line-height:150%;">一听大师的学习推文里已经用一张图对这篇文章进行了总结，如下：<span style="font-family: 宋体; line-height: 150%; font-size: 16px;"></span></p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_32_.jpeg' data-backh="318" data-backw="554" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwStVmT9v6lbYsek6AZ21DliaiaSEr4M3EbNucjO7Jy8iaTHiaCwaibibiak4Itw/0?wx_fmt=png" data-oversubscription-url="http://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_jpg/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwST3ibL5bTzgtzuT7Wo4GRqgFMxTxCn73x2MLmRxKrMUUhmechIuxJPtw/0?wx_fmt=jpeg" data-ratio="0.66066" data-s="300,640" data-type="jpeg" data-w="554" style="max-width: 650px;" data-original-style="width: 100%;height: auto;" data-index="32" src="http://pubimage.360doc.com/wz/default.gif" _width="100%" alt="图片" data-fail="0"></p><p style="margin: 0px 0px 16px; line-height: 150%;">关于B2亚分型详细的链接内容请点击：</p><p style="margin: 0px 0px 16px; line-height: 150%;">医学美图：B2血管的亚分型及意义</p><p style="margin: 0px 0px 16px; line-height: 150%;"><span style="text-decoration-line: underline;"><span style="line-height: 150%; letter-spacing: 1px; font-size: 16px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">Hidenori Kimura, Masao Yoshida<span style="font-family:宋体;">，</span><span style="font-family:Times New Roman;">et al.</span></span></span><span style="text-decoration-line: underline;"><span style="line-height: 150%; letter-spacing: 1px; font-size: 16px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">Preoperative indicators of misdiagnosis in invasion depth staging of esophageal cancer: Pitfalls of magnifying endoscopy with narrow‐band imaging</span></span><span style="text-decoration-line: underline;"><span style="line-height: 150%; letter-spacing: 1px; font-size: 16px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">.</span></span><em><span style="text-decoration-line: underline;"><span style="line-height: 150%; letter-spacing: 1px; font-size: 16px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">Digestive Endoscopy</span></span></em><em><span style="text-decoration-line: underline;"><span style="line-height: 150%; letter-spacing: 1px; font-size: 16px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">&nbsp;2019.</span></span></em><span style="text-decoration-line: underline;"><span style="line-height: 150%; letter-spacing: 1px; font-size: 16px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">&nbsp;DOI:&nbsp;</span></span><span style="text-decoration-line: underline;"><span style="line-height: 150%; letter-spacing: 1px; font-size: 16px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">10.1111/den.13464</span></span><span style="font-family: 宋体; line-height: 150%; letter-spacing: 0px; font-size: 16px; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">&nbsp;</span></p><p style="margin: 0px 0px 16px; line-height: 150%;">上述文献里提到B2的区域长径小于6mm或者糜烂周围的B2血管（下<strong>图a</strong>）应该考虑EP/LMP，当病灶看到以下特征时要考虑有SM2-3浸润：</p><p style="margin: 0px 0px 16px; line-height: 150%;"><span style="background-color: rgb(0, 0, 0); color: rgb(255, 251, 0);">&nbsp;1</span><span style="color: rgb(255, 255, 255); background-color: rgb(0, 0, 0);">.</span><span style="color: rgb(255, 255, 255);">&nbsp;</span><span style="background-color: rgb(217, 33, 66); color: rgb(255, 255, 255);">结节状突起</span>：大小&gt;2-3毫米，高于1毫米（下<strong>图b</strong>）；</p><p style="margin: 0px 0px 16px; line-height: 150%;"><span style="background-color: rgb(0, 0, 0); color: rgb(255, 251, 0);"> 2</span><span style="color: rgb(255, 255, 255); background-color: rgb(0, 0, 0);">.</span><span style="color: rgb(255, 255, 255);">&nbsp;</span><span style="background-color: rgb(217, 33, 66); color: rgb(255, 255, 255);">厚度</span>：充气后病变形状变化不大或粘膜下肿瘤样抬高（下<strong>图c</strong>）。</p><p style="margin: 0px 0px 16px; line-height: 150%;"><span style="background-color: rgb(0, 0, 0); color: rgb(255, 251, 0);">&nbsp;3</span><span style="color: rgb(255, 255, 255); background-color: rgb(0, 0, 0);">.</span><span style="color: rgb(255, 255, 255);">&nbsp;</span><span style="background-color: rgb(217, 33, 66); color: rgb(255, 255, 255);">明显凹陷区</span>：凹陷较深和易于识别的凹陷区边缘（下<strong>图d</strong>）▼</p><p style="text-align: center;"><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_33_63219.jpeg' data-backh="486" data-backw="554" data-before-oversubscription-url="https://mmbizhttp://www.360doc.com/content/24/1103/16/mmbiz_png/icZlaJuiccU1biaAiaEukuFRVk5XxBAlUgwSTGNJub0scuEWfFo0XJYQeQzicuc3QSsrav1Od4RZvMVZbp4P4L19Fgw/0?wx_fmt=png" data-ratio="0.95307" data-s="300,640" data-type="png" data-w="554" style="width: 677px !important; height: 593.903px !important;" data-original-style="width: 100%;height: auto;" data-index="33" src="http://pubimage.360doc.com/wz/default.gif" _width="100%" alt="图片"></p><p style="margin: 0px 0px 16px; line-height: 150%;"><span style="background-color: rgb(121, 123, 170); color: rgb(255, 255, 255);">&nbsp;这里的6mm的界限与前面提到的 B2-Narrow（小于4mm）有点区别，但是本人觉得这个内镜下的测量本也有一定的主观性，所以差1、2mm并不是非常的重要。</span></p><p style="margin: 0px 0px 16px; line-height: 150%;">当然，可以同时使用EUS来判断病灶的深度，会提高深度判断的正确率。</p><p style="margin: 0px 0px 16px; line-height: 150%;">以上为此次学习笔记：食管表浅癌学习小结——诊断篇。后续会有治疗篇。本片整理学习笔记内容部分来源于扫地僧一听、雨夜de小筑的公众号以及小山恒男《ESDのための食道癌術前診断》以及《胃与肠》杂志和英文文献的内容。特别鸣谢扫地僧一听、雨夜的小筑的公众号带来的大量的学习精华。<span style="text-align: justify;"></span></p><p><img doc360img-src='http://image109.360doc.com/DownloadImg/2024/11/0316/_34_.jpeg' style="margin: 32px auto 34px; display: block; border-radius: 8px; width: 578px !important; height: 42px !important;" data-type="jpeg" data-ratio="0.05917" data-w="578" data-original-style="margin: 32px auto 34px;display: block;border-radius: 8px;" data-index="34" src="http://pubimage.360doc.com/wz/default.gif" _width="578px" alt="图片"></p><p></p> </td> </tr> </tbody>