色素内镜提高基层医院大肠癌早期诊断水平的价值研究  

Study on the value of chromoendoscopy in improving the early diagnosis level of colorectal cancer in primary hospitals

作　　者：陈函清 周初夏 谢红燕[2] CHEN Hanqing ZHOU Chuxia XIE Hongyan(Department of Gastroenterology, Linhai Second People＇s Hospital in Zhejiang Province, Linhai 317016, China Department of Oneologieal Surgery, Taizhou Central Hospital in Zhejiang Province, Taizhou 318000, China)

机构地区：[1]浙江省临海市第二人民医院消化内科,浙江临海317016 [2]浙江省台州市中心医院肿瘤外科,浙江台州318000

出　　处：《中国现代医生》2017年第4期28-31,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2016ZHB037)

摘　　要：目的 研究色素内镜提高基层医院大肠癌早期诊断水平的价值。方法选择我院2015年1月~2016年9月收治的214例大肠黏膜病变患者作为研究对象,随机进行分组;对照组107例,采取常规内镜检查,不进行内镜染色,并行单纯病理活检;观察组107例,使用0.4%靛胭脂加0.2%醋酸黏膜染色剂对大肠黏膜进行染色,并对不染色和浅染色区进行病理活检;比较两组患者的病理活检结果、病理活检率及诊断率,以病理诊断结果为标准,比较观察组染色前后大肠癌的诊断符合率。结果观察组炎性或增生性息肉70例、腺瘤25例、癌或癌变12例;对照组炎性或增生性息肉69例、腺瘤27例、癌或癌变11例,两组患者的病理活检结果比较,差异无统计学意义(P>0.05);观察组病理活检率显著低于对照组,腺瘤诊断率、癌、癌变诊断率均显著高于对照组,差异有统计学意义(P<0.05);观察组染色前大肠癌的诊断符合率为1.87%,染色后大肠癌的诊断符合率为11.21%,观察组染色后大肠癌的诊断符合率显著高于染色前,差异有统计学意义(P<0.05)。结论应用色素内镜,有助于鉴别大肠黏膜病变的病理类型,可提高大肠癌早期诊断水平及病理活检成功率,且操作安全简便,适用于基层医院,值得推广使用。Objective To study the value of chromoendoscopy in the early diagnosis of colorectal cancer in primary hospitals. Methods A total of 214 patients with colorectal mucosal lesions who were admitted to our hospital from January 2015 to September 2016 were selected as research subjects and randomly divided into two groups. 107 cases in the control group were given routine endoscopy, without endoscopic staining, and a simple pathological biopsy was car- ried out; 107 cases in the observation group were treated with 0.4% indigo rouge and 0.2% acetic acid mucosal stain to stain the coloreetal mucosa, and the non-staining and light staining areas were hiopsied; the biopsy results, pathological biopsy rate and diagnostic rate were compared between the two groups. Pathological diagnosis was taken as the stan- dard, and the diagnostic coincidence rate of colorectal cancer was compared before and after staining. Results In the observation group, there were 70 cases of inflammatory or hyperplastic polyps, 25 cases of adenoma, 12 cases of cancer or eancerization; in the control group, there were 69 cases of inflammatory or proliferative polyps, 27 cases of adenoma, and 11 eases of cancer or eancerization. There was no significant difference between the two groups in the biopsy re- suits （P〉0.05）; the rate of pathological biopsy rate in the observation group was significantly lower than that in the con- trol group. The diagnostic rate of adenoma, cancer and cancerization was significantly higher than that in the control group, and the differences were statistically significant（P〈0.05）; the coincidence rate of coloreetal cancer was 1.87% before staining and 11.21% after staining in the observation group. The diagnostic coincidence rate of colorectal cancer in the observation group before staining was significantly higher than that after staining, and the difference was statisti- cally signifieant（P〈0.05）. Conclusion The application of chromoendoscopy is beneficial to identifying the pathological types of col

关 键 词：大肠癌 色素内镜 病理活检 早期诊断 

分 类 号：R736[医药卫生—肿瘤]