靛胭脂-美兰双重染色法诊断早期胃癌及上皮内瘤变的临床价值  

Clinical application value of indigo carmine-methylene blue double staining in diagnosis of early gastral cancer and intraepithelial neoplasia

作　　者：罗丹[1] 谭诗云[1] 卢思超[1] 梁静静[1] 

机构地区：[1]武汉大学人民医院消化内科,湖北武汉430060

出　　处：《胃肠病学和肝病学杂志》2009年第6期530-532,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨内镜下靛胭脂-美兰双重染色法对早期胃癌及癌前病变的临床诊断价值。方法就诊病人行常规内镜检查,发现可疑病灶者随机分为2组,染色组行内镜下靛胭脂-美蓝染色后活检;对照组不染色,肉眼判断病灶,常规活检。结果共入选240例,染色组和对照组各120例,染色组中检出早期胃癌25例、上皮内瘤变58例,对照组中分别检出8例、20例,两组检出率差异有统计学意义(P<0.05);染色组65例出现明显染色分界区,早期胃癌和上皮内瘤变检出率分别为35.4%和63.1%,无明显染色分界区(55例)的检出率分别为3.6%和30.9%,出现明显染色分界区早期胃癌及癌前病变的检出率均明显高于无明显染色分界区(P<0.05)。结论内镜下靛胭脂-美兰双重染色可显著提高早期胃癌和癌前病变的检出率,明显的染色分界区对于早期胃癌和癌前病变诊断有一定的指示意义。Objective To evaluate the clinical value of indigo carmine-methylene blue double staining in detection and diagnosis of gastral lesions. Methods After conventional electronic endoscopic diagnosis, the patients who were found doubtful lesions were randomly divided into 2 groups; endoscopic dye group was directly sprayed with indigo carmine-methyline blue, then biopsy; the control group was not stained, determined by the naked eye and conventional biopsy. Results Two hundred and forty patients were adopted, 120 cases of each group; in the endoscopic dye group, 25 early cancers and 58 intraepithelial neoplasia were found, while in the control group 2 cases and 20 cases respectively, and the detection rates of the two groups had significant differences （ P 〈 0.05 ）. After staining, there were 65 eases appeared obvious watershed area, in which the detection rates of early cancer and intraepithelial neoplasia were 35.4% and 63.1% respectively, while in non-watershed area （55 cases） , they were 3.6% and 30.9% respectively, and both of the detection rates of early cancers and precancerous lesions in obvious watershed area were significantly higher than those in non-watershed area （P 〈0. 05）. Conclusion Indigo carmine-methylene blue double staining improves the detection rates of early gastral cancer and precancerous lesion, especially in the watershed area.

关 键 词：靛胭脂-美兰双重染色 早期胃癌 上皮内瘤变 

分 类 号：R735.2[医药卫生—肿瘤] R730.4[医药卫生—临床医学]