摘要
目的为提高食管癌的早期诊断率,寻找Lugol液内镜下染色的最佳方法,并评价其临床应用价值。方法常规电子胃镜检查病人中发现食管表浅病变者290例,随机分为不染色组154例和染色组136例,不染色组直接在病变处活检取材;染色组分为单染组和重染组各68例,内镜直视下在食管粘膜上均匀喷洒2%Lugol液,分别行一次喷洒(单染组)和二次喷洒(重染组),之后仔细观察粘膜着色情况,在染色异常区多点咬取活检并送病理检查,然后将染色情况与相对应的病理检查结果进行对照。结果①染色组早期癌诊断率65.4%(89/136)显著高于不染色组(P<0.01);②重染组不染色例数(46例)、鳞癌诊断率(76.5%)、癌灶数目(69个)均显著高于单染组(P<0.05);③单染组不典型增生诊断率(30.9%)高于重染组(P<0.01)。结论食管病变Lugol液染色呈不染色或浅染色病例提示癌变或癌前病变,Lugol液重染法染色在早期癌检出及范围判断方面优于单染法染色,值得推广应用。
Objective To raise the early diagnosis rate of esophageal cancer, explore the best Lugol＇s stai-ning method under the endoscopy, and evaluate its value of clinical application. Methods Routine electronic gastroscopy found 290 patients with esophageal superficial lesions and divided them into two groups： nonstain- ing 154 and staining 136. Take biopsy directly from the pathological changes in nonstaining group. Staining group was divided into single staining and redyeing in average. Spraying 2% Lugol＇s solution uniformly in esophageal mucosa under the endoscopy, the single staining once and the redyeing twice. Then observe the staining condition of mucosa carefully. Take biopsy from the multiplaces of unusual staining districts and send them to patho -check, then compare staining conditions with corresponding patho -result. Results ①Early cancer diagnosis rate of staining group （65.4%） was far higher than the rate of nonstaining（ p 〈0.01 ） ; ② Nonstaining examples of redyeing （46）, diagnosis rate of squamous cell carcinoma （76.5%）, numbers of cancer focus （69） was all far higher than single staining （ p 〈 0.05 ）; ③Dysplasia diagnosis rate of single staining group （30.9%） was higher than redyeing group （ P 〈0.01 ）. Conclusion The cancerous and precancerous lession were liable to occur in cases with non -and light Lugol＇s staining groups, the Lugol＇s redyeing is more effective than the single staining in detection of early esophageal cancer and judgement of scope, and deserves generalization and application.
出处
《中原医刊》
2006年第17期3-4,共2页
Central Plains Medical Journal
关键词
Lugol溶液
不同染色法
诊断
早期食管癌
Lugol＇s solution
Different staining method
Diagnosis
Early esophageal carcinoma
