摘要
目的 :评价色素镜 (纤维内镜下行粘膜碘染 )对提高食管癌高发区无症状人群食管癌各级癌前病变检出率的意义以及碘染对获取手术切除大体标本癌旁各级病变组织的影响。方法 :常规食管纤维内镜观察后 ,在食管表面喷洒体积分数为 2 %的卢戈液染色 ,根据染色情况分别取活检组织进行组织病理学检查。采取同样的卢戈溶液对手术切除的食管标本作碘染色 ,并根据染色结果 ,分别取材作进一步的组织病理学分析。结果 :纤维内镜下碘染后 ,可观察到清晰的片状不染区 ,以及花斑状 ,点状和条状不染区。手术切除标本碘染后也出现相似的变化。对染色区和不染区分别取材 ,发现手术切除标本碘染区的各级癌前病变检出率明显高于不染区 (P <0 .0 5 ) ,特别是间变和原位癌病灶。 2 35例无症状人群色素镜检查组 (碘染组 )基底细胞过度增生和间变的检出率分别为 6 4 % (114 /179)和 74 % (14 /19) ,均明显高于非碘染组 36 % (6 5 /179)和 2 6 % (5 /19) (P <0 .0 5 )。但无症状人群碘染组染色区取材仍发现 4 %的间变检出率。结论 :色素镜 (碘染色 )能明显提高无症状人群食管癌前病变的检出率。手术切除标本行碘染色是获取各级癌前病变的有效手段。
Aim: To evaluate the significance of esophageal mucosa iodine staining in detection of different esophageal precancerous lesion from the symptom free subjects at high incidence area for esophageal cancer and to determine the effect of iodine staining on acquiring different lesions from the adjacent esophageal cancer tissues.Methods:Lugol's iodine solution (2%) was used to stain the esophageal mucosa under endoscopy during the mass survey. The stained and unstained mucosa were biopsied for histopathological analysis. The similar solution was applied to esophageal surgical specimen for enriching the precancerous lesions.Results: Different patterns of unstained mucosa by iodine solution were observed as flat point, toung, and irregular area.The similar results were observed on surgical specimen staining. The detection rates for different precancerous lesions increased apparently after iodine stain, both in surgical specimen and mucosal biopsy, especially for dysplasia and carcinoma in situ, The detection rates for basal cell hyperplasia and dysplasia in 235 symptom free subjects with iodine staining were 64% (114/179) and 74% (14/19), which was much higher than in those without iodine staining 36%(65/179)and 26%(5/19) ( P <0.05). But, 4% of dysplasia lesion was observed in stained mucosa from the symptom free subjects. Conclusions: Colour endoscopic examination (iodine staining) could increase the detection rate of esophageal precancerous lesions form the symptom free subjects.Iodine stain was a powerful method to acquire the different precancerous lesions from the surgical esophageal specimens. Colour endoscopy could decrease error caused by esophageal sampling procedure.
出处
《郑州大学学报（医学版）》
CAS
北大核心
2002年第6期729-732,共4页
Journal of Zhengzhou University(Medical Sciences)
基金
国家杰出青年科学基金 3 0 0 2 5 0 16
河南省高校创新人才工程基金
河南省医药卫生创新人才工程基金资助项目
