摘要
[目的]探究蓝激光内镜联合化学染色对上消化道早癌及癌前病变的诊断价值。[方法]回顾性分析2019年1月至2021年12月行胃镜检查的患者6 332例,根据患者所用内镜及检查过程不同分为蓝激光组与白光组,比较两组患者上消化道早癌及高级别上皮内瘤变、低级别上皮内瘤变及癌前状态的检出情况。[结果]蓝激光组上消化道癌及高级别上皮内瘤变检出率为1.63%(42/2 576),高于白光组的0.85%(32/3 756),差异有统计学意义(χ^(2)=8.017,P=0.005)。蓝激光组低级别上皮内瘤变及癌前状态检出率为41.15%(1 060/2 576),高于白光组的37.78%(1 419/3 756),差异有统计学意义(χ^(2)=7.282,P=0.007)。蓝激光组食管、贲门、胃的活检率均高于白光组,差异有统计学意义(χ^(2)=4.069,P=0.044;χ^(2)=4.010,P=0.045;χ^(2)=28.757,P<0.001);蓝激光组对癌性病变及高级别上皮内瘤变早诊率高于白光组,差异有统计学意义(χ^(2)=5.367,P=0.021)。[结论]蓝激光内镜联合化学染色可以提高活检率,从而提高上消化道早癌及高级别上皮内瘤变、低级别上皮内瘤变及癌前状态的检出率、早诊率,有利于上消化道癌早诊早治项目的推广。
[Objective] To compare the detection rate of blue laser endoscopy combined with chemical staining and white light endoscopy for early upper gastrointestinal cancer and precancerous lesions. [Methods] The clinical and endoscopic data of 6 332 patients undergoing gastroscopy from January 2019 to December 2021 were retrospectively analyzed, including 2 576 patients receiving blue light endoscopy(blue laser group) and 3 756 receiving white light endoscopy(white light group. The detection rates of early upper gastrointestinal cancer, high grade intraepithelial neoplasia, low grade intraepithelial neoplasia and precancerous lesions were compared between the two groups. [Results] The detection rate of upper gastrointestinal cancer and high grade intraepithelial neoplasia in the blue laser group was 1.63%(42/2 576), which was higher than that of the white light group(0.85%, 32/3 756)(χ^(2)=8.017, P=0.005). The detection rate of low grade intraepithelial neoplasia and precancerous lesions in blue laser group was 41.15%(1 060/2 576),which was higher than that in white light group(37.78%, 1 419/3 756)(χ^(2)=7.282, P=0.007). The biopsy rate of esophagus, cardia and stomach in blue laser group was significantly higher than that in white light group(χ^(2)=4.069, P=0.044;χ^(2)=4.010, P=0.045;χ^(2)=28.757, P<0.001), the rate of early diagnosis in the blue laser group was higher than that in the white light group(χ^(2)=5.367,P=0.021). [Conclusion] Blue laser endoscopy combined with chemical staining can increase the biopsy rate, thus increase the detection rate and early diagnosis rate of upper gastrointestinal cancer and high-grade intraepithelial neoplasia, low-grade intraepithelial neoplasia and precancerous state, which promotes the early diagnois and treatment of upper gastroiutestinal cancer.
作者
花海洋
王爱琳
李建辉
郝欣
蒋海森
HUA Hai-yang;WANG Ai-lin;LI Jian-hui;HAO Xin;JIANG Hai-sen(Chengde Central Hospital,Chengde 067000,China;Chengde Medical College,Chengde 067000,China;Affiliated Hospital of Chengde Medical University,Chengde 067000,China)
出处
《肿瘤学杂志》
CAS
2022年第6期485-489,共5页
Journal of Chinese Oncology
基金
2019年度河北省医学科学研究课题计划(20191297)。
关键词
蓝激光内镜
化学染色技术
上消化道早癌
检出率
早诊率
blue laser endoscopy
chemical staining
early upper gastrointestinal cancer
detection rate
early diagnosis rate
