窄带成像联合放大内镜对早期食管癌的诊治价值  

Narrow-band imaging combined with magnification endoscopy in the diagnosis and treatment of early esophageal cancer

作　　者：韩玉芹 刘萱[2,3,4] 俞力[2,3,4] 冀明[2,3,4] 张澍田[2,3,4] 

机构地区：[1]北京市通州区第二医院消化科,北京101102 [2]首都医科大学附属北京友谊医院消化科 [3]首都医科大学消化病学系 [4]北京市消化疾病中心,北京100050

出　　处：《实用医院临床杂志》2011年第1期45-47,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨窄带成像技术（NBI）联合放大内镜对早期食管癌的诊断及指导治疗中的作用。方法选择2006年3月至2010年5月82例同时经普通内镜、NBI联合放大内镜、卢戈氏碘染色后发现食管黏膜可疑病变患者，并进行上皮乳头内毛细血管袢（IPCL）分型，最后取标本作病理检查。结果NBI对病变的检出率高于普通内镜，差异有统计学意义（P〈0．05）；对早期癌及高度异型增生的检出率与碘染色相同（均为100％），对低度恶性倾向的病变的检出率低于碘染色，差异有统计学意义（P〈0．05）；早期癌及高度异型增生IPCL分型多在Ⅳ～Ⅴ2型（占92．3％），低度恶性倾向病变多在Ⅱ-Ⅲ型（占87．5％）。结论NBI与碘染色均可以提高早期食管癌及高糜异型增生的检出率；NBI与放大内镜联合可初步判断病变的良恶性质及病变的深度，对指导治疗有着重要的作用。Objective This study aimed to explore the advantage of combined use of narrow band imaging （ NBI ） and magnification endoscopy in the diagnosis and treatment of early esophageal cancer. Methods Eighty-two patients were enrolled from March 2006 to May 2010. All of them were examined by ordinary endoscopy,NBI endoscopy and Lugoul＇s iodine solution staining. Their epithelial papillary capillary loops （IPCL） were examined and classified into different types. Finally, biopsies were taken from all suspicious lesions. Results For early esophageal cancer and high. degree of hyperplasia,the detection rate of NBI was significantly higher than that of ordinary endoscopy （ P 〈 0.05 ）. However, there was no difference between NBI and Lugoul＇s iodine solution staining for that. For low-grade malignant lesions, the detection rate of NBI was lower than that of Lugoul＇s iodine solution staining （ P 〈 0. 05 ）. About 92. 3% of IPCL of early stage esophageal cancer and high degree of hyperplasia belonged to type Ⅳ～Ⅴ2, and 87. 5% of lowgrade malignant lesions were type Ⅱ-Ⅲ. Conclusion NBI and Lugoul＇s iodine solution staining can raise the detection rate of early esophageal cancer and high degree of hyperplasia. The combination of NBI and magnification endoscopy is helpful to discriminate malignant lesions, and it plays an important role to guide their management.

关 键 词：窄带成像技术 内镜 卢戈氏碘染色 食管癌 上皮乳头内毛细血管袢 

分 类 号：R735.1[医药卫生—肿瘤] R443.8[医药卫生—临床医学]