染色内镜技术在上消化道早癌诊断中的临床研究

Clinical Value of Chromoendoscopy in the Diagnosis of Early Gastroesophageal Cancer

目的研究染色内镜技术在消化道早癌诊断中的临床价值。方法选择2011年5月—2014年7月我院内镜中心检查的60例疑似消化道早癌病变患者作为研究对象,将其分为两组:染色组(30例)和非染色组(30例)。染色组胃黏膜用美蓝或靛胭脂染色,食管黏膜用卢格氏液染色。发现疑似早癌后活检送病理。非染色组内镜下发现疑似早癌后活检送病理。根据发现的早癌及癌前病变所占比例确定染色内镜在早癌诊断中的意义。结果染色组病例病理活检发现早癌8例(26.7%),癌前病变12例(40.0%);非染色组发现早癌4例(13.3%),癌前病变5例(16.7%)。非染色组未检出早癌及癌前病变病例重新行染色内镜后,又发现早癌及癌前病变各3例。结论染色内镜技术在消化道早癌诊断中可以显著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 observe the clinical value of chromoendoscopy in the diagnosis of early gastroesophageal cancer. Methods 60 patients suspected of early gastroesophageal cancer diagnosed in endoscopic center of our hospital from May 2011 to July 2014 were selected and divided into staining group and non-staining group, 30 cases in each group, with gastric mucosa stained with methylene blue or indigo carmine and the esophageal mucosa with Lugo＇s solution respectively, suspicious early cancer was being biopsied and pathologically examined, non-staining group was conducted the same procedure, the significance of chromoendoscopy in the diagnosis of early cancer was determined according to the proportion of early and precancerous lesions. Results 8 cases（26.7%） of early cancer and 12 cases（40.0%） of precancerous lesions by biopsy and pathological examination were observed in staining group, 4 cases（13.3%） and 5 cases（16.7%） respectively in non-staining group and 3 respective cases were determined by repeat chromoendoscopy in the cases undetected in non-staining group. Conclusion Chromoendoscopy can significantly improve the accuracy of diagnosis and pathological biopsy for early cancer and precancerous lesions. The method is simple and safe, which is worthy of promotion in primary hospital.