内镜下Lugol液染色联合ras蛋白检测对早期食管癌诊断的研究  

A Study of Chromoendoscopy Combined with Examination of ras Protein in Early Esophageal Cancer

作　　者：陈萍[1] 

机构地区：[1]焦作市人民医院胃镜室,河南焦作454000

出　　处：《肿瘤基础与临床》2009年第2期153-154,共2页journal of basic and clinical oncology

摘　　要：目的探讨内镜下卢戈氏(Lugol)液染色联合ras蛋白检测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120例随机分为染色组和对照组,各60例。用复方碘溶液(Lugol)对染色组进行食管黏膜染色检查,并于不染色或淡染色区进行病理活检,行ras蛋白检测;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38例,活检发现早期食管癌10例(16.67%),中重度异型增生12例(20.00%);对照组发现早期食管癌5例(8.33%),中重度异型增生6例(10.00%),两组食管癌诊断率比较差异有统计学意义(P<0.05)。在所有59例活检组织中,ras蛋白阳性18例(30.51%),其中中重度不典型增生和鳞癌组ras蛋白表达明显高于对照组(P<0.01)。结论通过染色内镜对高危易感人群进行筛检,对上述检查结果阳性患者行内镜下取活组织病理检查,同时进行ras蛋白分析,可以提高早期食管癌的诊断率。Objective To investigate the significance of Lugol＇ s iodine staining combined with examination of ras protein in early esophageal cancer. Methods Esophageal mucosa of 120 critical cases with esophageal carcinoma were dyed by Lugol＇ s solution orthopticly in endoscopy, the lesions founded was biopsied with pathologic method and the expressions of ras protein were examined by immunohistochemistry. Biopsy was performed depending on the doctor＇ s clinical experience in the control, which was not performed staining. Results There were 38 areas unstained of 60 patients including 12 places of moderate-severe hyperplasia, 10 places of early squamous cellcarcinoma. Pathological examinations in the control discovered that 5 cases（ 10.00% ） of esophageal cancer and 6 cases of middle-severe dysplasia were diagnosed. Significant difference of the diagnostic rate of esophageal cancer was observed between the two groups. The positive rate of ras protein was 30.51% （18/59） in all the cases. There was significant difference in moderate-severe hyperplasia and squamous cell carcinoma compared with the contrast group（P 〈 0.01 ）. Conclusion Screening of critical people with chromoendoscopy following biospy, pathologic detection and ras protein examination could increase diagnostic rate of early esophageal carcinoma.

关 键 词：早期食管癌 卢戈氏液 RAS蛋白 免疫组织化学 

分 类 号：R730.4[医药卫生—肿瘤] R735.1[医药卫生—临床医学]