内镜下食管碘染在癌前病变及早期食管癌诊治中的应用价值

The Application Value of Esophagus Iodine Staining by Endoscopy in Diagnosis and Treatment of Early Stage Esophageal Carcinoma

目的:探讨食管碘染色在食管癌前病变及早期食管癌诊治中的应用价值。方法:在2011年1月至2013年1月间对我科胃镜检查肉眼疑似微小和浅表粘膜病变者行食管碘染,阳性者行多点活检。结果:560例疑食管粘膜病变者碘染后有414例不染或浅染,碘染阳性者活检病理诊断食管癌25例、早癌10例、重度不典型增生63例、中度不典型增生31例、轻度不典型增生23例、炎症96例,检出率分别为6%、2.4%、15.2%、7.5%、5.6%、23.2%。23例碘染确定切除范围后行粘膜切除术患者,标本边缘均无病变累及。结论:食管碘染能提食管高早癌及癌前病变的诊断率,并可为内镜下食管粘膜切除及进展期食管癌外科切除确定手术范围提供参考,该方法值得在临床推广应用。

Objective： To discuss the application value of esophagus iodine staining in the diagnosis and treatment of early stage esophageal carcinoma. Methods： From Jan. 2011 to Jan. 2013, patients with suspicious tiny or shallow mucosa esophagus lesions visible to the naked eyes detected by endoscopy accepted esophagus iodine staining, the positive cases accepted multiple biopsy. Results： Among the 560 cases with suspicious lesion of esophagus mucosa who accepted iodine staining,414 cases couldnt be stained or could be stained with understain iodine,25 cases with positive iodine staining were diagnosed as esophageal carcinoma by pathology analysis , ten cases with early stage carcinoma,63 cases with severe atypical hyperpasia,31 cases with moderate atypical hyperpasia,23 cases with mild atypical hyperpasia, and 96 cases with inflammation. The detection rate of each lesion above was 6% ,2.4%, 15.2%, 7.5% ,5.6% and 23.2% ,respectively. Twenty-three cases accepted mucosa resection according to the range confirmed by iodine stai- ning, and the fringes of sample were not implicated with lesion. Conclusion： Esophagus iodine staining can rise the diagnostic rate of early carcinoma and precancerous lesions. It can also help to confirm the surgery range of esophagus mucosa resection by endoscopy and the surgical resection of progressive stage esophageal carcinoma. It is worthy of wide applying in clinical practice.