色素胃镜对胃早癌及癌前病变的诊断价值  

Diagnostic value of chromoendoscopy in early gastric cancer and precancerous lesions

作　　者：张韵婷[1] 操寄望[1] 季梦遥[1] 董卫国[1] 

机构地区：[1]武汉大学人民医院消化内科,湖北武汉430060

出　　处：《胃肠病学和肝病学杂志》2016年第5期513-516,共4页Chinese Journal of Gastroenterology and Hepatology

基　　金：湖北省自然科学基金资助(2013BCB014)

摘　　要：目的探究色素胃镜在胃早癌及癌前病变诊断中的应用价值。方法对武汉大学人民医院365例胃镜检查发现可疑胃黏膜病变者,用靛胭脂或美兰染液染色后取活检,结合病理分析,探讨内镜下病变部位颜色改变与活检病理结果的关系。结果365例患者中,靛胭脂染色组（n=168）病理诊断为癌、癌前病变及慢性炎等良性病变分别为27、53和88例,癌及癌前病变的整体检出率为47.6%,黏膜褪色、着色不良及染色正常检出率为100%、36.9%、5.4%,差异有统计学意义（χ^2=81.999,P〈0.01）。美兰染色组（n=197）检出癌、癌前病变及慢性炎分别为17、88、92例,癌及癌前病变的检出率为53.3%,深蓝色、淡蓝色及正常染色分别为98.1%、44.5%和3.8%,差异有统计学意义（χ^2=71.103,P〈0.01）。结论色素胃镜能鉴别胃黏膜病变,指导活检可提高胃早癌及癌前病变的检出率。Objective To investigate the diagnostic value of chromoendoscopy in early gastric cancer and precancerous lesion. Methods 0.4% indicarmine or methylene blue solution was sprinkled to the lesions of 365 patients who received routine endoscopy. Biopsy was taken in order to study the relationship between staining and pathological results. Results In indicamine group （n = 168） , there were 27 early cancers and 53 precancerous lesions, the total detection rate of early cancer and precancerous lesions was 47.6%. The detection rates of the unstaining, minor staining and normal staining lesions apartly were 100% , 36.9% and 5.4% , the difference was statistically significant （X2 = 81. 999,P 〈 0.01 ）. In methylene blue group （n = 197） , there were 17 early cancers and 88 precancerous lesions with the detection rate of 53.3%. The detection rates of staining dark blue, light blue and normal satined lesions were 98.1%, 44.5% and 3.8%, there was a statistically significant diference （X2 = 71. 103, P 〈 0.01）. Conclusion Chromoendoscopy with indiearmine or methylene blue solution can identify gastric lesions and improve the detection rate of early gastric cancer and precancerous lesion significantly.

关 键 词：色素胃镜 靛胭脂 美兰 胃早癌 癌前病变 

分 类 号：R735.2[医药卫生—肿瘤]