早期大肠癌的黏膜染色诊断及内镜治疗

Clinical effects of mucosal staining on the diagnosis and endoscopic therapy of early colorectal cancer

目的探讨黏膜染色对早期大肠癌的诊断价值及早期大肠癌的内镜治疗效果。方法使用0.4%的靛胭脂对393例结肠镜检查发现的小病变进行黏膜染色处理,观察并记录腺管开口情况,对其进行分型,对发现的早期大肠癌进行内镜下直接切除或者行EMR术。结果在393例结肠镜检查出的微小病变中,发现早期大肠癌患者22例。在腺管开口分型中,ⅢL型中早期大肠癌占22.0%(9/41),Ⅴ型中早期大肠癌占40.6%(13/32),其中20例行内镜下治疗。结论黏膜染色可更清晰观察早期小病变的腺管开口分型,提高早期大肠癌的诊断率。内镜治疗是早期大肠癌安全有效的治疗措施。

Objective To investigate the clinical effects of mucosal staining on the diagnosis and endoscopic therapy of early olorectal cancer. Methods Three hundred and ninety-three cases of mucosa were stained with 0. 4% indigo carmine when the result of colonoscopy showed that there were small lesions,the gland openings were observed and recorded,and typing after mucosal. The early colorectal cancer should be removed by endoscopic mucosal resection directly. Results Twenty-two cases in 393 cases of small lesions were diagnosed as early colorectal cancer. In the types of gland openings,9 cases in type ⅢL were diagnosed as early colorectal cancer,accounting for 22%（ 9/41）,and early colorectal cancer in type V accounting for 40. 6%（ 13/32）,and among them,20 cases accepted the endoscopic treatment. Conclusions Mucosa staining can observe clearly the small lesions of the crypt type clearly,and improve the level of early diagnosis of early colorectal cancer. Endoscopic therapy is safe and effective for early colorectal cancer.