醋酸-美蓝双重染色在CAG病理分型诊断中的价值  

Value of double vital staining with acetic acid and methylene blue in diagnosis of CAG pathologic types

作　　者：揭晓明[1] 王洪斌[2] 陈林[2] 游斌[2] 刘志鹏[2] 邹利全[2] 

机构地区：[1]解放军324医院质控科,重庆400020 [2]解放军324医院消化科,重庆400020

出　　处：《西南国防医药》2015年第10期1053-1055,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨醋酸-美蓝双重染色在慢性萎缩性胃炎病理分型诊断中的价值。方法 92例经确诊为慢性萎缩性胃炎的患者,随机分为醋酸-美蓝双重染色组(32例)、美蓝染色组(30例)和盲法活检组(30例)。所有患者常规服用二甲硅油等消泡剂后行普通白光胃镜检查,醋酸-美蓝双重染色组对可疑病灶处依次应用醋酸及美蓝染色后活检,美蓝染色组仅用美蓝对病灶进行染色后活检,盲法活检组仅凭操作者个人经验对可疑病灶处进行活检。所有病例均取4块组织活检,且均由同一高年资内镜医师完成,病理切片检查也由同一位经验丰富的病理医师完成。结果病理检查发现:醋酸-美蓝双重染色组中,伴肠化者20例,检出率为62.5%,不典型增生者9例,检出率为28.1%;美蓝染色组中,伴肠化者14例,检出率为46.7%,不典型增生者5例,检出率为16.7%;盲法活检组中,伴肠化者10例,检出率为33.3%,不典型增生者2例,检出率为6.7%。经检验发现,不论是肠化生,还是不典型增生,双重染色组检出率较其他两组明显要高(P<0.05)。结论醋酸-美蓝双重染色在慢性萎缩性胃炎病理分型诊断、判定病灶范围上有较大的应用价值。Objective To discuss t he value of double vital staining with acetic acid and methylene blue in the diagnosis of chronic atrophic gastritis（CAG） pathologic types. Methods 92 patients finally diagnosed as CAG were randomly divided into acetic acid and methylene blue staining group（32 cases）, methylene blue staining group（30 cases）, and blind biopsy group（30 cases）. All the patients took antifoam agents like dimeticone before ordinary gastroscopy. The suspicious focuses in the double staining group were stained with acetic acid and methylene blue before the biopsy. The focuses in the methylene blue staining group were only stained with methylene blue before the biopsy. The suspected focuses in the blind biopsy group only received the biopsy according to the handler＇s personal experience. All the cases were taken 4 tissue pieces to the biopsy performed by the same senior endoscopists.The pathology biopsy was also performed by the same experienced pathologist. Results The pathological examination indicated that in the double staining group there were 20 cases of intestinal metaplasia with the detection rate of 62.5% and 9 cases of atypical hyperplasia with the detection rate of 28.1%; in the methylene blue staining group, there were 14 cases of intestinal metaplasia and 5ones of atypical hyperplasia with the detection rates of 46.7% and 16.7%, respectively; in the blind biopsy group, there were 10 cases of intestinal metaplasia and 2 case of atypical hyperplasia with the detection rates of 33.3% and 6.7%. The detection rates of both intestinal metaplasia and dysplasia in the double staining group were higher than those in the other two groups（P 0.05）.Conclusion Double vital staining with acetic acid and methylene blue has a great application value in the diagnosis of the lesion area and CAG pathologic types.

关 键 词：萎缩性胃炎 黏膜 诊断 染色法 

分 类 号：R365[医药卫生—病理学]