卢戈氏液染色联合NBI技术诊断早期食管癌及癌前病变的价值  

Application of Lugol’s solution staining combined with NBI technique in the diagnosis of early esophageal cancer and precancerous lesions

作　　者：李静宇 常卫华 王自启 常达 王彦玲 钞利娜 Li Jingyu;Chang Weihua;Wang Ziqi;Chang Da;Wang Yanling;Chao Lina(Department of Gastroenterology,the People’s Hospital of Hebi,Hebi 458030,China)

机构地区：[1]鹤壁市人民医院消化内科,鹤壁458030

出　　处：《中国实用医刊》2023年第7期80-82,共3页Chinese Journal of Practical Medicine

基　　金：2020年中国消化道早癌医师共同成长计划立项项目(GTCZ-2020-HN-41-0003)

摘　　要：目的探讨卢戈氏液染色、内镜下窄带成像(NBI)联合诊断早期食管癌(EEC)及癌前病变的价值。方法抽取鹤壁市人民医院2021年1月至2021年12月收治的经常规胃镜检查为疑似食管病变患者4345例,所有患者均接受卢戈氏液染色、NBI检查,对检出有问题者进一步实施病理活检,共计病理活检634例。以病理活检结果作为标准,评价卢戈氏液染色、NBI检查及二者联合诊断EEC、癌前病变的价值。结果634例病理活检患者共计确诊EEC 91例,癌前病变81例(包括轻度不典型增生46例,中重度不典型增生35例)。卢戈氏液染色与NBI检查联合检出EEC、轻度不典型增生、中重度不典型增生的百分比均高于单一卢戈氏液染色、NBI检查,差异有统计学意义(P<0.05)。卢戈氏液染色、NBI检查单一诊断时,对EEC、轻度不典型增生、中重度不典型增生的检出率比较差异未见统计学意义(P>0.05)。结论针对常规胃镜检查疑似食管病变患者,先用卢戈氏液喷洒显示病变形态,再用普通NBI内镜观察微血管形态,可以清晰显示病灶微血管、微腺管开口的形态,提升对EEC、癌前病变的检出率。Objective To investigate the value of Lugol’s solution staining combined with narrow band imaging(NBI)in the diagnosis of early esophageal cancer(EEC)and precancerous lesions.Methods A total of 4345 patients with suspected esophageal lesions who underwent routine gastroscopy in the People’s Hospital of Hebi from January 2021 to December 2021 were selected for the study,and they all received Lugol’s solution staining and NBI examination.Further pathological biopsies were carried out for these patients with abnormal results.A total of 634 cases were biopsied.The results of pathological biopsy were used as the standard to evaluate the value of Lugol’s solution staining,NBI examination and combination of them in diagnosis of EEC and precancerous lesions.Results Ninety-one cases of EEC and 81 cases of precancerous lesions(including 46 cases of mild dysplasia and 35 cases of moderate to severe dysplasia)were definitely diagnosed among the 634 patients with pathological biopsy.The percentage of EEC,mild atypical hyperplasia,and moderate to severe hyperplasia detected by Lugol’s solution staining combined with NBI examination were significantly higher than those of Lugol’s solution staining alone and NBI examination alone,and the difference was statistically significant(P<0.05).There was no significant difference in the detection rates of EEC,mild atypical hyperplasia,and moderate to severe hyperplasia between Lugol’s solution staining alone and NBI examination alone(P>0.05).Conclusions For patients with suspected esophageal lesions during routine gastroscopy,firstly,spraying Lugol’s solution to display the lesion morphology;secondly,using ordinary NBI endoscopy to observe the microvascular morphology,in addition to clarifying the morphology of the actual lesion microvessels and microglandular duct openings.It can also improve the detection rates of EEC and precancerous lesions.

关 键 词：食管癌 早期 癌前病变 卢戈氏液染色 内镜下窄带成像 病理活检 不典型增生 

分 类 号：R735.1[医药卫生—肿瘤]