放大内镜诊断早期食管癌及癌前病变的临床价值

The clinical value of magnifying endoscopy diagnostic study of early esophageal cancer and precancerous lesions

目的探讨放大内镜诊断早期食管癌和癌前病变的临床价值。方法选取2011年6月至2013年5月收治的食管黏膜病变患者68例,行常规内镜检查,并选取同期体检健康者20例作为对照组。观察可疑病变部位上皮乳头内毛细血管袢(IPCL)的形态学改变,进行IPCL分型,通过组织活检进行病理学分析。结果放大内镜对食管癌范围和病变程度的诊断效果明显优于普通内镜(P<0.05)。正常对照组、食管炎、低级别癌变、高级别癌变和食管癌主要IPCL分型分别为Ⅰ型(100.0%)、Ⅱ型(85.1%)、Ⅲ型(50.0%)、Ⅲ型(60.0%)、Ⅳ型(66.7%)。结论放大内镜对早期食管癌及其癌前病变的诊断符合率较高,效果明显优于普通内镜,通过放大内镜IPCL形态学分型对早期食管癌及其癌前病变的诊断具有较高的临床价值。

Objective To investigate the clinical diagnostic value of magnifying endoscopy on early esophageal cancer and precancerous lesions. Methods 68 patients with esophageal mueosal lesions admitted to our hospital from June 2011 to May 2013 received usual routine endoscopic examination, and 20 cases of healthy people were selected as the control group simultaneously. Intraepithelial papillary capillary loops （IPCL） morphological changes of suspicious lesions were observed,IPCL typed,and pathological tissue biopsy analyzed. Results The effect of magnifying endoscopy in the diagnosis of the scope and severity of esophageal cancer was significantly better than those of the normal endoscopy （ P 〈 0. 05 ）. Major IPCL types of the normal control group, esophagitis,low levels of cancer, highgrade cancer and esophageal cancer were typeI （lO0.0%）,type II （85. l%）,type III （50.0%）,type III （60.0%） and IV type （ 66.7% ） respectively. Conclusion The magnifying endoscopy owns higher compliance rate for early diagnosis of e- sophageal cancer and precancerous lesions, which is better than ordinary endoscopy. In the diagnosis of early esophageal cancer and precancerous lesions, morphological typing of IPCL by magnifying endoscopy has high clinical value.