基层医院内镜下双重染色在食管癌及癌前病变诊断中的应用价值

Clinical Value of Double Staining under Endoscopy in Diagnosis of Esophagus carcinoma and Precancerous Lesion in Primary Hospital

目的 探讨基层医院内镜下双重染色在食管癌及癌前病变中的诊断价值.方法 选择2015年1月—2018年1月在新疆五家渠第六师医院内镜检查中发现食管可疑病灶的170例患者为研究对象,根据随机数字表法将入选者分为对照组和研究组各85例,对照组行卢戈尔碘染色,研究组行醋酸联合卢戈尔碘双重染色,对染色异常区进行病理活检,比较两种染色方法在食管癌及癌前病变中的检出率.结果 研究组食管癌及癌前病变中的检出率分别为90.48%(19/21)和100.00%(30/30),对照组食管癌及癌前病变检出率分别为80.95%(17/21)和76.67%(23/30),两组食管癌检出率差异无统计学意义(χ2=0.19,P＞0.05),两组食管癌癌前病变检出率差异有统计学意义(χ2=5.82,P＜0.05).结论 内镜下醋酸联合卢戈尔碘染色可提高食管癌癌前病变检出率,且具有操作简单、费用低廉等优势,适宜在基层医院推广使用.

Objective To investigate the diagnostic value of endoscopic double staining in esophageal cancer and precancerous lesions.Methods From January 2015to January 2018,a total of 170patients with suspicious esophageal lesions,which underwent endoscopy examination in Wujiaqu Sixth Hospital of Xinjiang,were divided into control group and study group according to random number table method (N=85 in each group).The control group adopted Rugol's iodine staining and the study group adopted acetic acid combined with Rugol's iodine staining. The staining abnormality were performed pathological biopsy for two groups,and compare the detection rates of two staining methods in esophageal cancer and precancerous lesions.Results The detection rates of esophageal cancer and precancerous lesions in the study group were 90.48%(19/21)and 100.00%(30/30),respectively.The,detection rates of esophageal cancer and precancerous lesions in the control group were 80.95%(17/21)and 76.67%(23/30), respectively.There was no significant difference in the detection rates of esophageal cancer between two groups(χ2= 0.19,P >0.05).There was significant difference in the detection rate of esophageal precancerous lesions between two groups (χ2=5.82,P <0.05).Conclusion Endoscopic acetic acid combined with Rugol's iodine staining can effectively improve the detection rate of esophageal precancerous lesions,and has the advantages of simple operation and low cost,which is suitable for popularization in primary hospitals.