窄带成像放大内镜联合超声微探头诊断早期食管癌及癌前病变的价值  

Evaluation of Narrow-band Imaging System with Magnfying Endoscopy Combined Miniprobe Sonography in the Diagnosis of Early Squamous Esophageal Cancer and Precancerous Lesions

作　　者：王强[1] 童强[1] 张卫国[1] 姜东升[1] 屠新华[1] 毛明芝[1] 雷华云[1] 

机构地区：[1]郧阳医学院附属太和医院消化内科,十堰442000

出　　处：《临床消化病杂志》2009年第4期217-219,共3页Chinese Journal of Clinical Gastroenterology

摘　　要：目的研究窄带成像放大内镜联合超声微探头对早期食管癌及癌前病变的诊断价值。方法58例经常规内镜观察有食管黏膜粗糙、糜烂、颜色异常、微隆起等可疑病变,首次病检均示慢性炎症患者,再次内镜检查时,对可疑病灶行微探头超声检查,在窄带成像放大内镜下观察病变部位上皮乳头内毛细血管袢的形态,并在其引导下对病变区行活组织病理检查,将放大内镜下毛细血管袢的形态结果与组织病理诊断对照研究后进行统计学分析。结果58例常规内镜及活检为慢性炎症者经窄带成像放大内镜联合超声并在其引导下对病变区行活组织病理检查确诊鳞癌10例(17.24%),其中早期食管癌8例,高级别瘤变4例(6.89%),低级别瘤变16例(27.58%),食管炎28例(48.27%)。食管癌组60.00%(6/10)为Ⅳ型上皮乳头内毛细血管袢(IPCL),40.00%(4/10)为Ⅲ型IPCL;高级别瘤变组75.00%(3/4)为Ⅲ型IPCL,25.00%(1/4)为Ⅳ型IPCL;低级别瘤变组,50.00%(8/16)为Ⅲ型IPCL,43.75%(7/16)为Ⅱ型IPCL,6.25%(1/16)为Ⅰ型IPCL;食管炎组85.18%(23/27)为Ⅱ型IPCL,11.11%(3/27)为Ⅰ型IPCL,3.71%(1/27)为Ⅲ型IPCL。食管癌、高级别瘤变的IPCL与食管炎的ILCL比较,差异有统计学意义(P<0.05)。结论窄带成像放大内镜联合超声微探头对早期食管癌及癌前病变有较高的诊断价值。Objective To evaluate narrow-band imaging （NBI） system with magnifying endoscopy combined miniprobe sonography in the diagnosis of early squamous esophageal cancer and precancerous lesions. Methods 58 cases with suspected and non-protrusion lesions detected by endoscopy were enrolled, whose pathological diagnosis were chronic inflammation. Then, miniprobe sonography were enrolled. The magnifying endoscopy images were graded as four patterns by intraepithelial papillary capillary loop（IPCL） changes by NBI. Biopsy tissue NBI with magnifying endoscopy combined miniprobe sonography underwent pathologic evalution. The comparison between the imaging patterns of endoscopy and histological diagnosis was evaluated. Results 58 cases pathology diagnosis narrow-band imaging system with magnifying endoscopy combined miniprobe sonography inelud- ed：10 cases （17.24%） were diagnosed pathologically squamous cancer including 8 cases of early esophageal cancer, 4 cases （6. 89% ） were high grade intraepithelial neoplasia, 16 cases （27. 58% ） low grade intraepithelial neoplasia,27 cases （48.27%） were chronic inflammation. 100% esophageal carcinoma and high grade intraepithelial neoplasia were Ⅳ, Ⅲ type IPCL,50.00% low grade intraepithelial neoplasia was Ⅲ type IPCL,43.75% was Ⅱ type IPCL, 85.18% esophagitis was Ⅱ type IPCL. The difference was significant between esophageal carcinoma, high grade intraepithelial neoplasia and esophagitis （ P 〈 0. 05）. Conclusion NBI with magnifying endoscopy combined miniprobe sonography is an effective method in the diagnosis of early squa- mous esophageal cancer and precancerous lesions.

关 键 词：食管肿瘤 诊断 超声内镜 窄带成像技术 放大内镜 

分 类 号：R735.1[医药卫生—肿瘤]