内镜下卢戈氏液染色普查食管早期癌的应用与观察

目的：探讨内镜下卢戈氏液染色法在普查食管早期癌的应用。方法：按要求普查257例。先在内镜下观察食管粘膜有无异常后，用1．2％卢戈氏液涂布染色，对呈现碘染色或碘不染色的不同案例，分别做指示性活检送病理检查。并观察分析内镜所见、碘染色有无与活检病理的关系。结果：内镜下正常，碘染色正常，活检正常率占67．32％，而碘不染例中多为食管慢性炎和不典型增生，活检正常率占28．29％，较前者明显低（P＜0．01）。内镜下异常且碘染例中，查出鳞癌2例，不典型增生22例，食管慢性炎等81例（39．51％）。后者同碘染色正常10例（19．23％）比较，有显著性差异（P＜0．05）。2例重度不典型增生，均在碘不染例中发现。结论：卢戈氏液染色法可提高食管早期癌及不典型增生的发现率，值得在临检和普查中应用。

Application of Endoscopic Lugol's Staining in Detecting Early Carcinoma of Esoph agus

Objective:The application of endoscopic Lugol's staining in detecting early carctionma of esophagus for survey in high-risk areas was observed.Method:1.2% Lugol's solution was adopted to stain esophageal carcinoma mucosa in 257 cases without any apparent features of esophageal disorder under endoscopy.And then multiple biopsies were taken differentaly for pathology from indicative areas of stained and unstained cases.And their correlation was analysed.Results:The cases demonstrating iodine stained areas were 52/257;the cases with iodine unstained areas were 205/257.The incidence of mornal histologic findings was 67.32%(35/52) in cases with normal endoscopic features and iodine well-stained areas.the incidence of normal histologic findings was 28.29%(58/205) in cases with normal endoscopic features but iodine unstained areas (mainly chronic inflammations and dysplasias of esophagus).The incidence of abnormal histoloic lesion in iodine and dysplasias of esophasgus).The incidence of abonrmal histoloic lesion in iodine unstained cases was significantly higer than those with iodine well-stained areas (P<0.01).Two squamous cell carcinoma of esophagus,22 dysplasias and 81 chronic inflammations of esophagus were detected in the cases of iodine unstained areaswith endoscopic abnormal features.The incidenc of histophatlogic lesions (mainly carcinoma and chronic inflammations of esophagus)in the unstained cases was significantly higher than those with incidence of histophathologic lesions (mainly carcinoma and chronic inflammations of esophagus) in the unstained cases was significantly higher than those with iodine well-stained areas (P<0.05).Two serious dysplaias were detected in the iodine unstained cases. Conclusions:Endocopic lugol's staining technique helps detecting suspicious areas where biopsies will be performed and aids to identify either severe dysplastic lesions or early carcinoma of esophagus in theses areas.