进展期食管癌全食管粘膜碘染色的作用

Mucosal iodine staining of entire esophagus in the diagnosis of advanced esophageal carcinoma

目的 观察全食管粘膜碘染色对进展期食管癌的诊断作用。方法 440例进展期食管癌行术前全食管粘膜碘染色检查,对不染、浅染、染色不均等染色异常区行粘膜活检,切除标本行次连续切片检查。结果55例有染色异常,其中表现为主癌灶外另发病灶48例,主病灶范围较染色前内镜所见明显扩大7例。51例因染色发现更改了手术方式,由胸内吻合改为颈部吻合。术后病理结果,鳞癌46例,中、重度异型增生8例,1例碘染色异常术后标本病理结果正常。结论 全食管粘膜碘染色对进展期食管癌具有一定的应用价值,有助于发现同时存在的其他病灶及进一步确定病灶范围。

Objective To observe the effectiveness of Lugol's chromoendoscopy of the entire e-sophagus on the diagnosis of advanced esophageal carcinoma. Methods Four-hundred and forty patients with advanced esophageal carcinoma were examined with lugols chromoendoscopy preoperatively. Biopsy was taken from non-stained area. The specimen obtained after esophagectomy were sectioned in sub-series. Results Abnormal stains were observed in 55 cases( 12. 5% )including 48 with multifocus,4 with extended lesions and 3 with both. The patterns of esophagectomy were changed in 51 cases due to abnormal finding of stains. Compared with the pathology specimen, the sensitivity and specificity of the stain for multifocus were 97. 9% and 85. 2% respectively. Conclusion It is useful in the patients with advanced esophageal carcinoma to perform a Lugol' s chromoendoscopy . More detailed information might obtain from the examination , particularly in finding out the multifocus lesions and outlining the extent of lesion.