色素内镜在早期胃癌及癌前病变诊断中的应用价值  

Clinical values of chromoendoscopy in early gastric cancer and precancerous lesions

作　　者：于劲[1] 邓磊[1] 王雷[1] 杨小军[1] 樊超强[1] 赵晓晏[1] 

机构地区：[1]第三军医大学新桥医院消化内科,重庆400037

出　　处：《中华消化病与影像杂志（电子版）》2012年第2期20-23,共4页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

摘　　要：目的探讨色素内镜在早期胃癌及癌前病变诊断中的应用价值。方法 2010年1至12月对第三军医大学新桥医院48例胃镜疑诊Ⅱc型早期胃癌患者,行醋酸联合靛胭脂染色进行色素内镜检查。比较白光内镜、色素内镜下病灶边界清晰程度。所有病变行黏膜下切除术(ESD)后,观察病变大小、部位、肉眼分型、病理诊断和侵犯深度等,并进行比较。结果 48例疑诊Ⅱc型早期胃癌病理诊断癌前病变22例(45.83%),分化型和未分化型早癌26例(54.17%)。全部48例患者ESD术后未发生并发症,术后病理学检查未发现癌残留。色素内镜对癌前病变、分化型早期胃癌边界的诊断优于白光内镜(χ2值分别为5.87、7.20,P<0.05)。色素内镜下清晰或不清晰病变的病灶大小、病灶位置、肉眼分型、病理诊断和病变侵犯深度等差异无统计学意义。结论色素内镜对早期胃癌及癌前病变边界的判断优于白光内镜。Objective To investigate the role of acetic acid joint indicarminum endoscope in diagnosis of early gastric cancer and precancerous lesions, and the characteristics of early gastric cancer. Methods The edge of suspected early gastric cancer and precancerous lesions was identified by white light endoscopy and pigment endoscope respectively. By acetic acid joint indicarminum dyeing, the form of lesions, crypt openings, and the laterally developmental border have been observed with endoscopy. After endoscopic submucosal dissection, the clinical characteristics such as the diameter, location, the type of pit pattern, the invasion depth and the histopathology diagnosis was compared. Results The detection rates of early gastric cancer and differentiated early gastric cancer diagnosed by pigment endoscopy were significantly higher than those in white light endoscopy （X2 = 5. 87,7. 20, P 〈 0.05 ）. In the 48 cases diagnosed by pigment endoscopy, there were 22 precancerous lesions （45.83%） , 26 cases of early gastric cancer （54. 17% ）. The histopathological diagnosis results indicated that precancerous lesion were 22 cases（45.83% ）, invasion submucosa 6 cases （ 12. 5% ）. No postoperative complications and residual tumor were left. Conclusion The identification of early gastric cancer with pigment endoscopy is better than white light endoscopy.

关 键 词：早期胃癌 癌前病变 色素内镜 病理 

分 类 号：R735.2[医药卫生—肿瘤]