色素内镜在上消化道早期癌及癌前病变的诊断价值

Diagnostic value for early cancer and precancerous lesions in the digestive tract under pigment endoscopy

目的研究色素内镜对上消化道早期癌及癌前病变的诊断价值。方法将内镜下216例食管黏膜病变患者分为两组,染色组108例用Lugol氏液对食管黏膜染色,并对不染色和浅染色区进行病理活检;对照组108例食管黏膜患者进行单纯病理活检。将内镜下220例胃黏膜病变患者分为两组,染色组110例用靛胭脂—美兰染色后进行病理活检,对照组110例胃黏膜病变患者进行单纯病理活检。结果食管染色组不染色或浅染色病例60例(55.6%),病理活检发现早期食管癌12例(11.1%),癌前病变6例(5.6%);胃染色组有69例(62.7%)不同程度染色,病理活检发现早期胃癌14例(12.7%),其中原位癌4例(3.6%),癌前病变9例(8.1%)。发现早期癌及癌前病变与对照组的诊断率比较差异有显著性(P<0.01)。结论色素内镜有助于提高上消化道早期癌及癌前病变的诊断率及病理活检准确率,方法简便安全,值得基层医院推广。

【Objective】To study diagnostic value of early cancer and precancerous lesions in upper gastroin-testinal under pigment endoscopy. 【Methods】216 cases of endoscopic esophageal mucosal lesions, staining group of 108 cases were treated with Lugol's solution staining of the esophageal mucosa, and non-staining and light stain-ing zone biopsy; Control group, 108 cases of esophageal mucosa in patients with a simple biopsy. 220 cases of endo-scopic gastric mucosal lesions, indigo dyeing group of 110 cases with rouge -methylene blue staining and biopsy in the control group of 110 cases gastric mucosal lesions in patients with a simple biopsy. 【Results】Esophagus didn't stain or stained pale group of 60 cases (55.6%), biopsy of 12 early esophageal cancer (11.1%), precancerous lesions in 6 patients (5.6%); Stomach stained group of 69 patients (62.7%) varying degrees of staining, biopsy detection of 14 early gastric cancer (12.7%), which carcinoma in situ in 4 cases, 9 cases of precancerous lesions (8.1%). Early detection of cancer and precancerous lesions and the diagnostic rate of the control group were significantly statisti-cally significant (P <0.01).【Conclusions】Upper gastrointestinal endoscopy can help to improve pigment early can-cer and precancerous lesions and biopsy accuracy rate, the method is simple, safe and worthy of spreading in the primary hospitals.