碘染色在食管癌高发区直接内镜普查中的应用和效果

Endoscopic screening of esophageal cancer with iodine staining in high risked area

目的 研究碘染色在食管癌高发区直接内镜普查中的应用和效果以及对比碘染色前后癌和异型增生的发现率。方法 在高发现场对3 022例40～69岁人群进行内镜检查,观察并记录食管黏膜颜色、形态和黏膜下血管纹理,碘染色后再观察其颜色变化,并行组织活检。结果 经活检组织学诊断,并发现食管癌131例,中度和重度异型增生659例。碘染色前后发现食管癌分别为57例、111例,发现中度和重度异型增生154例、505例。统计学上差异有显著性意义。结论 内镜检查中碘染色可明显提高浅表食管癌和异型增生的发现率。

Objective To evaluate the application and effect of endoscopic screening directly with i-odine stain in high risked area of esophageal cancer and compare the detecting rate of cancer and dysplasia before and after iodine stains. Methods In the high risked area of esophageal cancer, endoscopic exam were directly performed in 3 022 people, aged 40 - 69 years with iodine staining and biopsy, then observing and recording the alternation of color and morphology of mucbsa and texture of submucosal blood vessels before and after iodine staining. Results One hundred and thirty one cases of esophageal carcinoma and 659 cases of moderate and severe dysplasia were diagnosed by biopsy; the discovery of esophageal cancer before and after iodine stain were 57 ( 1. 9% ) and 111(3.7%) cases, while of moderate and severe dysplasia were 154(5. 0% ) and 659(21. 8% ) cases respectively with significant statistical differences. Conclusion The mucosal iodine staining under endoscopy markedly increased the detecting rates of early superficial esophageal cancer and dysplasia ( moderate and severe) .