色素内镜对早期胃癌和癌前病变诊断效果的临床研究

Clinical study of chromoendoscopy in the diagnosis of early gastric cancer and precancerous lesions

目的比较靛胭脂醋酸混合液(AIM)染色在不同病变上的色调变化情况,提高早期胃癌和癌前期病变的检出率。方法胃镜检查时,先用普通白光观察胃黏膜情况并照相记录,然后通过活检钳道插入喷管,在可疑病变处喷洒AIM液40 mL,观察颜色变化,术中对可疑病变取活检,浸泡于福尔马林液中,送病理学检查。结果正常胃黏膜组织喷洒AIM后黏膜呈均匀的淡蓝色;慢性胃炎组织喷洒AIM后病变区域和周围正常区域黏膜均呈蓝色;肠上皮化生组织喷洒AIM后病变区域黏膜首先变白,非异常区域黏膜呈蓝色,呈现出一种在蓝色背景下的白色岛状图像;异型增生和早期胃癌组织喷洒AIM后病变区域退色,周围黏膜呈现蓝色。结论内镜下醋酸联合靛胭脂染色有助于早期胃癌及癌前病变的发现和检出,可提高活检的准确性。

Objective To compare the changes of color tone in different lesions by sputum acetate acetate(AIM) staining and to improve the detection rate of early gastric cancer and precancerous lesions.Methods During gastroscopy,the gastric mucosa was observed with ordinary white light and photographed.Then,the biopsy forceps were inserted into the nozzle,40 mL of AIM solution was sprayed on the suspected lesion,and the color change was observed.The biopsy of the suspected lesion was taken during surgery.In the formalin solution,a pathological examination was sent.Results The mucosa of the normal gastric mucosa was uniformly blue after spraying AIM.The mucosa of the lesion area and the surrounding normal area showed blue after the AIM was sprayed on the chronic gastritis tissue.After the AIM was sprayed on the intestinal metaplasia,the mucosa of the lesion first turned white.The non-abnormal area mucosa was blue,showing a white island image on a blue background;the dysplasia and early gastric cancer tissue were sprayed with AIM and the lesion area faded,and the surrounding mucosa showed blue.Conclusion Endoscopic acetic acid combined with rouge staining can help the early detection of gastric cancer and precancerous lesions,and improve the accuracy of biopsy.