吞水音图检查对食道及贲门部疾病的诊断价值

Preliminary Exploration on Value of Phagaquosonography in Diagnosing Diseases of Esophagus and Cardia

用吞水音图诊断法对我国某食道癌高发区１８５４名４０岁以上村民食道及贲门部疾病进行了普查。其中３００例吞水音图异常者，作了胃镜和组织学检查。结果表明，音阁提示食道炎和贲门炎者分别占１９．６％和７６．３％，而胃镜下诊断者分别占１１．０％和４６．０％，其检出率均明显高于胃镜（Ｐ＜０．０１）。与组织学比较，音图对食道炎和贲门炎的诊断符合率分别为６１．０％和９５．６％；音图提示食道癌１例，货门癌１１例，该１２例与胃镜下诊断及部位完全相符。经组织学检查，８例证实为癌，其中１例为食道癌，７例为贲门癌。音阁与组织学诊断癌的总符合率为６６．７％，其余４例为１、１级不典型增生。在７例贲门癌中，３例为早期贲门癌，早期癌占７例癌的４２．９％。这是迄今为止，国内外作为用于贲门癌普查手段中检出早期癌最高者。

A general check-up results including 1854 villagers of forty and over in a certain high incidence region of cancer of esophagus examined by phagaquosonography were reportel. Three hundred cases with abnormal phagaquosonogram among the villagers were simultaneously examined by fibrogastroscopy and histology. In the 300 cases with abnormal phagaquosonogram, esophgitis and inflammation of cardia made up 19.6% and 76.33% respectively, but fibrogastroscopy found out that the two diseases made up 11.0% and 46.0% respectively. The cases discovered by phagaquosonography are obviously higher as compared with fibrogastroscopy (P<0.01). The cases of the aforesaid two diseases were diagnosed in 61 % and 95.6% respectively by histology.In addition, phagaquosonography found out 12 cases of cancer (1 with cancer of esophagus and 11 with cancer of cardia).In diagnosing cancers of esophagus and cardia, phagaquosonography and fibrogaastroscopy held identical results.Eight cases.(1 with cancer of esophagus and 7 with cancer of cardia) among them were vertified by histology. 66.7% of phagaquosonographic diagnosis conform to histology.Another 4 cases were diagnosed as atypical hyperplasia of Ⅱ and Ⅲdegrees. Early cancer of cardia were confirmed in 3 of 7 cases with cancer of cardia(42.9% ).The results obtained showed that up till phagaquosonography has the highest detection rate in the general check-up methods of cancer of cardiaat home and abroad.