超声微探头联合卢戈(lugol)液染色诊断早期食管癌及癌前病变61例

Miniprobe sonography combining with Lugol’s staining for diagnosis of early esophageal cancer and precancerous lesions

目的 研究超声微探头联合卢戈液染色对早期食管癌及癌前病变的诊断价值。方法 61例患者经胃镜检查发现食管有非隆起性可疑病变，首次病理检查均提示慢性炎症。对可疑病灶行卢戈氏碘染色，微探头超声引导下对卢戈氏碘不染色区、浅染区行活组织病理检查。结果61例患者确诊为鳞癌10例（16．4％），其中早期食管癌6例，3例病理诊断为食管炎，微探头超声高度怀疑食管癌，后再次取活检（1-3次）证实为食管癌；不典型增生18例（29、5％），其中轻度不典型增生9例，中度不典型增生5例，重度不典型增生4例，慢性炎症33例（54．1％）。结论 超声微探头联合卢戈氏染色对食管病变有较高的诊断价值，尤其是早期食管癌及癌前病变。对微探头超声高度怀疑食管癌而活检阴性的病理需多次活检，以提高诊断的阳性率。

Objective To investigate clinic value of detecting early esophageal cancer and precancerous lesions with miniprobe sonography combined with Lugol＇ s staining. Methods Sixty-one cases who were pathologically diagnosed as chronic inflammation with suspected and non-protrusion lesions under endoscopy were enrolled. Lugol＇ s iodine was sprayed on the esophageal lesions. Then, miniprobe sonography guiding multiple biopsies were taken for pathological analysis from unstained and light yellow areas. Results Ten cases （16.4%） were diagnosed pathologically as squamous cancer including 6 cases of early esophageal cancer. 3 cases who were pathologically diagnosed as chronic inflammation at first, but were highly suspected esophageal cancer detected with miniprobe sonagraphy, were identified as squamous cancer by pathological examination again. 18 cases （29.5%） showed different level dysplasia including mild dysplasia （9 cases） ,moderate dysplasia （5 cases） and severe dysplasia （4 cases）. 33 cases（54. 1% ） were chronic inflammation. Conclusions Miniprobe sonography combining with Lugol＇ s staining is an effective method in diagnosing esophageal suspected lesions, especially early esophageal cancer and precancerous lesions. For the suspected lesions that were detected by miniprobe sonography, multiple biopsies can improve positive rate of diagnosis.