内镜下Toluidine Blue和Lugol’s Solution双重染色在食管早期癌和浅表癌诊断中的意义  

EVALUATION OF THE DOUBLE STAINING OF TOLUIDING BLUE AND LUGOL'S SOLUTION IN DETECTING EARLY, SUPERFICIAL CANCER OF ESOPHAGUS

作　　者：邓登豪[1] 朱海杭[1] 罗金燕[2] 张军[2] 王康敏[2] 左红梅[3] 

机构地区：[1]江苏省扬州大学医学院附属苏北医院消化科,225001 [2]西安医科大学二附院 [3]江苏省扬州大学医学院附属苏北医院16病区

出　　处：《中国内镜杂志》2001年第2期21-23,共3页China Journal of Endoscopy

摘　　要：目的 :为评价内镜下甲体胺兰和卢戈氏液双重染色在食管早期癌和浅表癌诊断中的意义。方法 :对 10 8例食管癌可疑患者进行食管粘膜双重染色 ,对TB染色区和LS不染色区 (以下简称为目标区 )进行活检病理诊断 ,癌组织经手术后病理证实。结果 :染色后病理诊断结果 :常规内镜检查发现食管进展期癌 10例 ,有粘膜粗糙感 2 1例 ,小片状粘膜剥脱 7例 ;染色病理诊断后发现原位癌 1例 ,浅表癌 5例 ,10例食管癌发现跳跃灶 2例 ,异型增生 15例 ,单纯增生和慢性炎 37例 ,放疗后复查发现 2例 ;10 8例患者 (48例有症状 ,6 0例无症状 )总染色阳性率 5 7.4% ,其中早期癌阳性率为 5 .5 % ,异型增生的阳性率为 13.8% ,有症状组总阳性率 79.1%高于无症状组 40 % (P <0 .0 1) ,其中癌的检出率有症状组 10 .4%高于无症状组 1.6 % (P <0 .0 5 ) ,不典型增生检出率有症状组 2 2 .9%高于无症状组 6 .6 % (P <0 .0 5 )。结论 :内镜下双重染色有助于食管早期癌、表浅癌及癌前病变的诊断 ,并有助于指导食管癌的治疗。Objective:To evaluate toluidine blue (TB) and Lugol's solution (LS) double staining in detecting early,superficial cancer of esophagus.Methods:TB and LS double staining was adopted to stain esophageal mucosa in 108 cases with suspected early malignancy for its diagnostic value.From unstained areas of LS and stained areas of TB multiple biopsies were taken for pathology.Results:The result revealed 10 progressive cancer,21 mucosa coarseness,7 mucosa exfoliation with rude endoscopy,and revealed 6 cancers (1 in situ cancer,5 superficial),15 dysplasia,2 skip focus (in 10 cancers),37 simple hyperplasia and chronic inflammation,2 distinctive focus in radiated cancer with double staining method.In 108 (48 cases had symptom and 60 cases had't)patients,The positive ones accounted for 57.4% of the total with 5.5% of early cancer and 13.8% of simple hyperplasia.The(Early cancer,dysplasias) positive percentage was higher in symptomic group(79.1%,10.4%,22.9%)than in asymptomic group (40%,1.6%,6.6%),(P<0.01,P<0.05,P<0.05).Conclusions:TB and LS double staining is useful for diagnosing superficial esophageal cancer and precancerous lesions,and can also provide information to treatment.

关 键 词：双重染色 食管早期癌 浅表癌 癌前病变 诊断 

分 类 号：R735.104[医药卫生—肿瘤]