内镜诊断上消化道多原发癌57例

目的　探讨上消化道多原发癌的部分特点及提高内镜对上消化道多原发癌的诊断率。方法　对上消化道多灶病例 ,分别对病灶和病灶之间的粘膜进行活检 ,必要时卢戈氏液染色后活检。结果　内镜检出同时性多原发癌 5 5例 ,异时性多原发癌 2例。检出癌灶 116个中早期癌灶 13个。食管—食管和食管—贲门多原发癌分别占 40 .4%和 2 8.1% ,食管一胃 2 6 .3 % ,其它 5 .2 %。结论　内镜是诊断上消化道多原癌的重要手段 ,内镜下染色可提高早期癌灶的诊断率。上消化道多原发癌以食管—食管和食管—贲门多见 ,其次为食管—胃多原发癌。

Diagnosis on 57 cases of multiple primary carcinoma of upper digestive tract by endoscopy

Objective To consider the several characteristic of multiple primary carcinoma(MPC)of the upper digestive tract and how to improve diagnostic rate of MPC of the upper digestive tract by endoscopy.Methods All the endoscopic biopsy specimens of lesions and mucosa between any two lesions were examined.Staining was performed with Lugol's iodine when being necessary. Results Fifty five cases of homochronous MPC and 2 cases of heterochronic MPC were diagnosed. Thirteen early cancer foci were found in 116 cancerous foci. The esophagus-esophagus MPC, esophagus-cardia MPC and esophagus-ventriculus MPC were 40.4%, 28.1% and 26.3% respectively, and the rest MPC 5.2%. Conclusions The endoscopic inspection is an important means for diagnose of the upper digestive tract MPC. Staining can improve diagnostic rate of early cancer foci .In the upper digestive tract MPC esophagus-esophagus MPC and esophagus-cardia MPC are common and esophagus-ventriculus is secondary.