醋酸-靛胭脂染色放大内镜在早期胃癌诊断中的作用研究  

Clinical values of acetate-indigo carmine stained magnifying endoscopy in the diagnosis of early gastric cancer

作　　者：周彩芳[1] 刘铁梅[1] 梁暖 

机构地区：[1]复旦大学附属中山医院青浦分院内窥镜室,上海201700

出　　处：《哈尔滨医科大学学报》2015年第1期60-62,共3页Journal of Harbin Medical University

基　　金：上海市青浦区科学技术发展基金资助项目(2012-19)

摘　　要：目的探讨醋酸-靛胭脂染色放大内镜在早期胃癌诊断中的作用。方法有上腹部不适症状的患者行常规内镜检查,并于病灶处进行醋酸-靛胭脂染色后活检。167例胃黏膜有可疑病灶的患者进一步行放大内镜检查后活检。常规内镜和色素内镜下取材部位选择病灶边界。经放大胃镜检查后取材部位选择病灶边缘胃小凹变化明显处。结果 167例胃黏膜可疑病灶醋酸-靛胭脂染色后活检,病理学检查发现早期胃癌5例(检出率3.00%),异型增生18例(检出率10.78%),肠上皮化生26例(检出率15.57%),分别高于常规胃镜检查活检的病理检查结果,其中早期胃癌为3例(检出率1.80%),异型增生为11例(检出率6.59%),肠上皮化生为19例(检出率11.38%),但差异不显著(P>0.05)。而染色放大胃镜检查后活检病理检查发现,早期胃癌10例(检出率5.99%),异型增生29例(检出率17.37%),肠上皮化生36例(检出率21.56%),分别高于染色胃镜检查结果,明显高于常规胃镜检出率。与常规胃镜检查结果相比,差异显著(P<0.05)。结论醋酸-靛胭脂染色放大胃镜能够指导内镜下胃黏膜病变的活检,早期胃癌、异型增生及肠上皮化生的检出率高,对早期胃癌的诊断具有优势。Objective To investigate the clinical value of acetate-indigo carmine stained magnifying endoscopy in the diagnosis of early gastric cancer. Methods The patients with suspected upper gastric diseases underwent endoscopy. After acetic acid joint indigo carmine dyeing,biopsies were also needed. The position of biopsies was suspicious lesions in gastric mucosa. In addition,167 patients with suspicious lesions underwent magnifying endoscopy with gastric mucosal biopsies. The position of biopsies was suspicious lesions in gastric pits. Results In 167 cases of gastric suspicious lesions,after acetic acid joint indigo carmine dyeing,5 cases of early gastric cancer,18 cases of dysplasia and 26 cases of intestinal metaplasia were found,and the detection rate were 3. 00%,10. 78% and 15. 57%,respectively,which were greater than biopsies only（ 1. 80%,6. 59% and 11. 38%,P 0. 05）. After magnifying endoscopy,10 cases of early gastric cancer,29 cases of dysplasia and 36 cases of intestinal metaplasia werefound,and the detection rate were 5. 99%,17. 37% and 21. 56%,respectively,which were greater than biopsies only（ P 0. 05）. Conclusion Acetate-indigo carmine stained magnifying endoscopy can guide a biopsy,and improve the detection rate of the early gastric cancer,dysplasia and intestinal metaplasia.

关 键 词：放大内镜 醋酸-靛胭脂染色 病理学诊断 早期胃癌 

分 类 号：R735.2[医药卫生—肿瘤] R730.49[医药卫生—临床医学]