染色内镜联合黏膜切除术对胃黏膜上皮不典型增生及早期胃癌诊断价值的研究

Study of the clinical value of chromoendoscopy combined with endoscopic mucosal resection in the diagnosis of gastric epithelial dysplasia and early gastric cancer

目的研究内镜下黏膜染色联合经内镜黏膜切除术对胃黏膜上皮不典型增生及早期胃癌诊断价值。方法将145例患者随机分为内镜下黏膜染色联合经内镜黏膜切除术组(实验组)和单纯染色活检组(对照组),实验组用0.5%美蓝溶液染色后对异常着色区行内镜下黏膜切除术并送病检;对照组美蓝溶液染色后对异常着色区域常规方法取活检。结果实验组发现不典型增生31例(43.7%),早期胃癌8例(11.3%);对照组发现不典型增生23例(31.1%),早期胃癌4例(5.4%),实验组不典型增生、早期胃癌发现率明显高于对照组,差异有统计学意义(P<0.05)。结论内镜下黏膜染色联合经内镜黏膜切除术可进一步提高胃黏膜上皮不典型增生及早期胃癌的诊断率。

Objective To evaluate the clinical value of chromoendoscopy and endoscopic mucosal resection in the diagnosis of gastric epithelial dysplasia and early gastric cancer. Methods One hundred forty-five patients were randomly divided into two groups：Sevevty-one patients, which accepted chromoendoscopy and endoscopic mueosal resection in lesion areas, served as experiment group; 74 patients, which only accepted chromoendoscopy and conventional endoscopy biopsy, served as control group. Results There are 31 patients with dysplasia and 8 patients with early gastric cancers in experimental group, 23 patients with dysplasia and 4 patients with early gastric cancers in control group. Conclusion Chromoendoscopy combined with endoscopic mucosal resection has important clinical value in diagnosis of gastric epithelial dysplasia and early gastric cancer.