碘染色对早期食管癌及癌前病变的诊断价值

On the Iodine staining for early diagnosis of esophageal cancer and precancerous lesions

目的探讨胃镜下碘染色对早期食管癌及癌前病变的诊断价值。方法对本院2007-01-2009-12186例常规胃镜下观察食管黏膜有轻度异常的患者,用碘液配制成2.5%卢戈液染色,观察病变染色程度,并进行活组织病理学检查,结合病理结果进行统计,将病理结果与染色结果进行比较。结果常规胃镜检查发现186例食管异常病变,其中食管鳞形细胞癌43例,食管重度不典型增生8例,食管中度不典型增生32例,食管轻度不典型增生15例,慢性食管炎61例,鳞状上皮增生27例。卢戈液染色后,早期食管癌及癌前病变主要表现为卢戈液不染和淡染,其准确性为62.03%;卢戈液不染诊断早期食管癌及食管重度不典型增生准确性高达95.8%。碘不染、淡染区检出食管早癌及异型增生概率高于染色区(χ2=35.139,P<0.05)。结论胃镜下卢戈液染色有助于食管病变的鉴别诊断,可以提高异型增生及早期食管癌的检出率,对食管表浅病变有重要诊断价值。

Objective To study the endoscopic iodine staining in early diagnosis of esophageal cancer and precancerous lesions.Methods In our hospital from January 2007 to December 2009 186 cases of conventional endoscopic observation of esophageal mucosa in patients with mild abnormalities with povidone-iodine preparation of 2.5% Lugol＇s staining and staining extent of lesions and conducted histopathological examination of living,combined with pathological results statistics,pathology results with the staining results were compared.Results Of conventional endoscopic examination revealed 186 cases of Abnormal esophageal lesions,including esophageal squamous cell carcinoma,43 cases of severe esophageal dysplasia in 8 cases,the esophagus moderate dysplasia,32 cases Esophageal mild dysplasia in 15 cases of chronic esophagitis in 61 cases,27 cases of squamous epithelial hyperplasia.Lugol＇s solution staining,early esophageal cancer and precancerous lesions manifested mainly Lugol＇s non-staining and light staining,accuracy of 62.03%;Lugol＇s solution does not dye the diagnosis of early esophageal cancer and esophageal accuracy of severe dysplasia as high as 95.8%.The detection rate of esophageal cancer and atypical hyperplasia in Lugol voiding lesions was significantly higher than that in Lugol staining lesions（χ2=35.139,P0.05）.Conclusions Endoscopic Lugol＇s Staining help the differential diagnosis of esophageal lesions can improve dysplasia and early esophageal cancer detection rate of superficial lesions of the esophagus has important diagnostic value.