关键词: 上皮内瘤变, 结直肠肿瘤, 手术治疗, 内镜切除

Abstract: Advances in the diagnosis and treatment of high-grade intraepithelial neoplasia of the colorectum        YANG Yang，FEI  Bing-yuan，WANG Qi，et al. Department of Gastrointestinal Colorectal and Anal Surgery，China-Japan Union Hospital of Jilin University，Changchun 130031，China 
Corresponding authors：XIE Zhongshi，E-mail: xiezs@jlu.edu.cn；SHEN Kexin，E-mail: shenkexin1314@jlu.edu.cn
Abstract    WHO recommended the new definition of "intraepithelial neoplasia" instead of "heterogeneous hyperplasia" and "carcinoma in situ"，emphasizing that intraepithelial neoplasia is a precancerous lesion and should be distinguished from the new definition of "intraepithelial neoplasia" replaces "heterogeneous proliferation" and "carcinoma in situ". The refinement of the concept puts forward higher requirements for the standards of clinical diagnosis and pathological diagnosis, and also puts forward more accurate requirements for the selection of treatment methods. For patients with high-grade intraepithelial neoplasia of the colorectum，endoscopic therapy should be preferred when the lesions have no obvious submucosal invasion，lymph node metastasis, vascular invasion，and contraindications of endoscopic therapy. In the presence of any of these risks，additional surgical treatment is recommended to achieve radical resection. Recommend adopting multidisciplinary team（MDT） model for comprehensive evaluation and individualized analysis，so as to provide the best diagnosis and treatment method for patients.

Key words: intraepithelial neoplasia, colorectal neoplasms, surgical treatment, endoscopic resection