216例内镜下碘染色诊断早期食管癌的临床对照研究

目的:探讨内镜下碘染色对早期食管癌的诊断价值。方法:将胃镜下有可疑食管病变的216例患者随机分为染色组和对照组各108例。用复方碘溶液对染色组进行食管粘膜染色检查,并于不染色或淡染色区进行病理活检。对照组不行碘染色,仅根据临床经验进行病理活检。结果:染色组不染色或淡染色60例(55.6%),发现食管癌12例(11.1%),其中早期食管癌2例,鳞状上皮异型增生6例(5.6%),其中中重度异型增生3例;对照组活检21例(19.4%),发现食管癌1例(0.9%),轻中度异型增生3例(2.8%)。两组食管癌诊断率的差异有统计学意义。结论:内镜下碘染色能减少食管粘膜活检误差,提高食管癌诊断率,有助于发现早期食管癌及其癌前病变,值得临床推广应用。

Clinical Control Investigation on Diagnosis of Early Esophageal Cancer Using Iodine Staining snder Endoscopy

Objective:To investigate the diagnostic value of early esophageal cancer using iodine staining under endoscopy.Methods: Two hundred and sixteen patients with suspected esophageal malignancy under endoscopy were randomly divided into staining group and control group. Each group had 108 cases. Lugols iodine was sprayed on esophageal mucosa under endoscopy and biopsy of unstained or tinged area by iodine was performed in the staining group. Biopsy was performed depending on the doctor's clinical experience in the control, which was not performed staining.Results: Sixty cases (55.6%) were unstained or tinged including 12 cases(11.1%) suffering from esophageal cancer (including 2 cases of early cancer), 6 squamous-cell dysplasia (including 3 middle-severe dysplasia) in staining group. Twenty one cases (19.4%) were performed biopsy in the control, among which 1 (0.9%) esophageal cancer and 3 (2.8%) light-middle dysplasia were diagnosed. Significant difference of the diagnostic rate of esophageal cancer was observed between the two groups. Conclusion: Iodine staining under endoscopy can decrease the error of esophageal mucosa biopsy, increase the diagnostic rate of esophageal cancer, and can help the detection of early esophageal cancer and it's precancerous lesion, thus it is worthy of clinical application and extending.