碘染色技术在食管癌高发区早癌诊断中的应用价值

Value of iodine staining technique in the diagnosis of esophageal early cancer in high incidence area of esophageal cancer

目的探讨食管癌高发区采用食管黏膜碘染色技术进行早癌诊断的临床应用价值。方法对食管癌高发的陕南地区2015-01~2015-12的12 777例患者进行白光内镜检查,根据镜下表现进行相应的活组织检查(白光组),2016-01~2016-12的12 226例患者进行常规碘染色检查及相应的活组织检查(碘染组),比较分析病理检查结果的差异。结果白光组病理证实低级别上皮内瘤变122例、高级别上皮内瘤变11例、早期癌3例;碘染组病理证实低级别上皮内瘤变335例、高级别上皮内瘤变32例、早期癌11例;碘染组较白光组的癌前病变及早期食管癌检出率差异有统计学意义(P<0.05)。结论对内镜检查患者进行常规食管碘染能提高食管癌前病变和早期癌的检出率,值得基层医院推广应用。

Objective To explore the clinical application value of iodine staining for early cancer diagnosis in high incidence area of esophageal cancer.Methods Totally 12 777 patients in 2015 were performed white light endoscopy（white light group）,and 12 666 patients in 2016 were performed regular iodine staining（iodine staining group）.The abnormal endoscopic tissues were performed biopsy.The differences of pathological examination results were compared.Results There were 122 cases of low grade intraepithelial neoplasia,11 cases of high-grade epithelial neoplasia and 3 cases of early cancer in white light group.There were 335 cases of low grade intraepithelial neoplasia,32 cases of high-grade epithelial neoplasia and 11 cases of early cancer in iodine staining group.There was a significant difference in detection rate of precancerous lesions and early esophageal cancer between iodine staining group and white light group（P〈0.05）.Conclusion Routine endoscopy iodine staining can improve the detection rate of esophageal precancerous lesions and esophageal early carcinomas in patients,and it is worth popularizing in grass-roots hospitals.