色素内镜对早期胃癌的诊断价值

背景: 胃癌是最常见的消化道恶性肿瘤之一,早期诊断是治疗的关键。目的: 探讨色素内镜在胃癌早期诊断中的价值。方法: 纳入2008年1月～2009年7月普通内镜检查示可疑胃黏膜病变者115例,比较普通内镜和色素内镜的总体诊断符合率和早期胃癌检出率。结果: 病理检查示,炎性增生27例(23.5%),胃溃疡57例(49.6%),早期胃癌15例(13.0%),进展期胃癌15例(13.0%),胃黏膜相关淋巴组织(MALT)淋巴瘤1例(0.9%)。色素内镜的总体诊断符合率和早期胃癌检出率均略高于普通内镜,但差异无统计学意义(92.1%对86.8%,P0.05;80.0%对66.7%,P0.05)。结论: 色素内镜可增加病灶清晰度,有提高总体诊断符合率和早期胃癌检出率的趋势,其临床应用价值还有待大样本研究证实。

Value of Chromoendoscopy in Detection of Early Gastric Cancer

Gastric cancer is one of the most prevalent cancers of digestive system. Early diagnosis is the key point for treatment of gastric cancer. Aims： To appraise the value of chromoendoscopy in the detection of early gastric cancer. Methods： One hundred and fifteen patients with abnormal gastric mucosal findings under conventional gastroscopy from January 2008 to July 2009 were enrolled to compare the overall diagnostic accuracy and detection rate of early gastric cancer by conventional endoscopy and chromoendoscopy. Results： Pathologic examination demonstrated that 27 （23.5%） patients had inflammatory hyperplasia, 57 （49.6%） had gastric ulcer, 15 （13.0%） had early gastric cancer, 15 （13.0%） had advanced gastric cancer and 1 （0.9%） had mucosa-associated lymphoid tissue （MALT） lymphoma. The overall diagnostic accuracy and detection rate of early gastric cancer by chromoendoscopy were slightly higher than those by conventional endoscopy, but the differences were not statistically significant （92.1% vs. 86.8%, P〉0.05; 80.0% vs. 66.7%, P〉0.05）. Conclusions： Chromoendoscopy can improve the clarity of gastric mucosal lesions and has a trend to increase the overall diagnostic accuracy and detection rate of early gastric cancer. The clinical application value needs to be elucidated by further study with larger samples.