Lugol’S液食管染色联合MUC2检测对Barrett食管的诊断价值

The study of the expression of MUC2 combined Lugol's solution staining Barrett's esophagus in the patients with Barrett's esophagus

目的使用Lugol’s液进行食管染色联合黏蛋白2(MUC2)检测对Barrett食管(BE)的诊断价值。方法对胃镜下初步诊断为BE食管的患者,分为A、B两组,A组为实验组24例,行2%Lugol’s液10-20ml食管染色,1-min3食管黏膜迅速染色,在食管不着色区取活检(靶向活检)2-4块送HE染色病理检查,同时行免疫组化检测MUC2表达情况;B组为对照组20例,在紧靠齿状线下方、齿状线舌形突出、齿状线上岛形橘红色黏膜处取活检2-4块,送HE染色病理检查。结果 A组HE染色病理诊断为BE21例,7例为肠化型,HE染色病理诊断的BE中有13例MUC2阳性表达;B组HE染色病理确诊为BE12例,其中3例为肠化型BE;两组BE检出率比较,差异有统计学意义(χ2=4.4,P<0.05);两组肠化型BE检出率亦有统计学意义(χ2=7.232,P=0.007<0.05)。结论 Lugol’s液食管染色进行靶向活检可以提高BE的诊断率,MUC2检测显著提高了肠化型BE的诊断率。

Objective To study the expression of MUC2 combined Lugol＇s solution staining in the patients with Barrett＇s esophagus.Methods All the 44 Barrett＇s esophagus were diagnosed by the endoscopy.They were randomized into two groups：group A（experiment group）,24 cases stained with 10 ～ 20ml Lugol＇s solution first.After 1 ～ 3min,2 ～ 4 Biopsies were taken from unstained areas.Group B（control group）,20 cases,2 ～ 4 biopsies were taken from orange areas of esophagus.The expression of the MUC2 were detected by immunohistochemistry in the group A.Results 21 cases in the A group were confirmed Barrett＇s esophagus by pathologist,And 7 cases were found the intestinal metaplasis in the Barrett＇s esophagus.And the MUC2 were positive in 13 cases.12 cases in the group B were confirmed Barrett＇s esophagus by pathologist,and 3 cases were found the intestinal metaplasis in the Barrett＇s esophagus.The detective rate of Barrett＇s esophagus was significant difference between group A and group B（χ2 = 4.4,P = 0.0362）.And the detection of the intestinal metaplasia was also significant difference Between group A and group B（χ2 = 7.232,P = 0.007）.Conclusion The Lugol＇s solution staining could increase the diagnostic rate of Barrett＇s esophagus,and combination of detecting the expression of MUC2 can increase the diagnostic rate of the intestinal metaplasia.