内镜下美兰-靛胭脂双重染色法诊断早期胃癌及癌前病变的临床价值

Clinical application value of indigo carmine-methylene blue double staining in diagnosis of early gastral cancer and precancerous lesions

目的探讨内镜下靛胭脂-美兰双重染色法诊断早期胃癌及癌前病变的临床价值。方法就诊病人行常规内镜检查,发现可疑病灶者随机分为两组,观察组行内镜下靛胭脂-美蓝染色后活检,对照组不染色,肉眼判断病灶,常规活检。结果观察组(83例)分别检出早期胃癌25例、不典型增生14例和萎缩性或肠化生21例,对照组(75例)分别检出12、11例和16例,观察组早期胃癌及癌前病变的检出率为72.29%。对照组早期胃癌及癌前病变检出率为52.00%,两组早期胃癌和癌前病变检出率比较,差异有统计学意义(P<0.05)。出现明显染色分界区的胃癌及癌前病变的检出率均显著高于无明显染色分界区(P<0.05)。结论内镜下靛胭脂-美兰双重染色能显著提高早期胃癌和癌前病变的检出率,对早期胃癌和癌前病变诊断具有一定的指示意义。

Objective To investigate the value of indigo carmine-methylene blue double staining in diagnosis of early gastral cancer and precancerous lesions. Methods After conventional electronic endoscopic diagnosis, the patients found doubtful lesions were randomly divided into observation group and control group. The observation group was directly sprayed with indigo carmine methyline blue, then biopsy. The control group was not stained, determined by the naked eye and conventional biopsy. Results 25 early cancers, 14 atypical hyperplasia and 21 atrophic/intestinal metaplasia were found in the observation group, while 12 cases, 11 and 16 cases in thecontrol group respectively, and the detection rates of the two groups had significant differences （P〈0.05）. After staining, there were 56 cases appeared obvious watershed area, in which the detection rates of early gastral cancer and precancerous lesions was 94.64%, while in non- watershed area （27 cases）, it was 25.93%, and the detection rate in obvious watershed area were significantly higher than that in non-watershed area （P〈0.05）. Conclusion Indigo carmine methylene blue double staining improves the detection rates of early gastral cancer and precancerous lesion, especially in the watershed area.