胃镜下联合染色观察方法对癌前病变及早期胃癌检出率的影响

The effect of combined staining under gastroscope on the detection rate of precancerous lesions and early gastric cancer

目的对比分析普通白光胃镜与联合染色(电子染色+靛胭脂染色)胃镜在早期胃癌和胃癌前病变检出中的差异。方法回顾性分析该院行胃镜检查的患者314例,分为观察组和对照组。观察组(n=157)在普通白光的基础上,用电子染色[内镜窄带成像(NBI)]技术观察胃黏膜变化,对可疑病变行化学技术(靛胭脂染色)染色后,再观察胃黏膜形态色泽的变化,着色异常的黏膜取活检送病理检查;对照组(n=157)采取普通白光胃镜观察胃黏膜,对黏膜异常者(红、白、凸、凹)取活检送病理检查。结果观察组诊断早期胃癌3例,低级别上皮内瘤变54例,高级别上皮内瘤变13例,阳性检出率为10.19%;对照组诊断早期胃癌1例,低级别上皮内瘤变42例,高级别上皮内瘤变7例,阳性检出率为5.10%,两组检出率比较,差异有统计学意义(X~2=8.29,P=0.041)。结论内镜下联合染色技术(电子染色+靛胭脂染色)可明显提高早期胃癌和癌前病变的检出率。

Objective A retrospective study was conducted to analyze the difference in the detection rate of early gastric cancer and pregastric cancer by ordinary white light gastroscopy and combined gastroscopy(electronic staining+indigo carmine staining).Methods Retrospective analysis was perfermed on 314 patients with gastroscopy were divided into two groups.Observation group(n=157)in ordinary white light,on the basis of observation and to use the technology of electronic dyeing,observe the changes in gastric mucosa,suspicious mucosa with abnormal stainingagain for chemical dyeing technology(iodine rouge dyeing)after observation gastric mucosa morphology change color,the color abnormal mucosa send take biopsy pathological examination;Control group(n=157)were observed with normal white light gastroscopy,and the abnormal mucosa(red,white,convex,concave)were biopsied for pathological examination.Results In the observing group,3 cases were diagnosed with early gastric cancer,the low level neoplasia intraepithelial was 54 cases,high level of intraepithelial neoplasia was 13 cases,positive detection rate was 10.19%.In the the control group,1 case was diagnosed with early gastric cancer,low level in neoplasia was 42 cases and high level in neoplasia was 7 cases,positive detection rate was 5.10%.The difference of positive detection rate between the two groups was statistically significant(χ2=8.29,P=0.041).Conclusion Endoscopic union dyeing technology(electronic dyeing+indigo carmine dyeing)can significantly increase the detection rate of early gastric cancer and precancerous lesions.