2000年国际癌症研究机构(LARC)为了规范治疗重新规定了胃肠道肿瘤的定义和诊断标准,引用了“上皮内瘤变”这一概念,强调上皮内瘤变属于癌前病变,应区别于恶性肿瘤的治疗方法。概念的细化给病理医师诊断上带来了困惑,而且在临床实践中对于治疗方式的选择提出了更高的要求。对于结直肠高级别上皮内瘤变,内镜下介入治疗为主,同时需根据切除术后病理标本结果决定是否追加外科手术及术后随访时间。建议采用多学科综合治疗协作组模式进行综合评估,个体化分析,为病人提供最佳的诊疗方式。In 2000, the International Agency for Research on Cancer (IARC) redefined the definitions and diagnostic criteria for gastrointestinal tumors to standardize treatment. The concept of “intraepithelial neoplasia” was introduced, emphasizing that intraepithelial neoplasia is a precancerous lesion and should be distinguished from malignant tumors in terms of treatment methods. The refinement of this concept has caused some confusion among pathologists in diagnosis and has also posed higher demands on the selection of treatment methods in clinical practice. For colorectal high-grade intraepithelial neoplasia, endoscopic intervention is primarily recommended. However, the decision on whether to perform additional surgical procedures and the postoperative follow-up period should be based on the pathological results of the resected specimens. It is recommended to adopt a multidisciplinary treatment collaboration model for comprehensive evaluation and individualized analysis to provide the best diagnostic and therapeutic approaches for patients.
