内镜下窄带成像结合卢戈氏液染色对食管早期癌及癌前病变的诊断价值  

The diagnostic value of narrow-band endoscopic imaging combined with lugol's fluid staining for early esophageal cancer and precancerous lesions

作　　者：彭樱花 谢志刚[1] 邓丽英[1] PENG Yinghua;XIE Zhigang;DENG Liying(Endoscopic Center,Yingde People's Hospital,Yingde 513000,China)

机构地区：[1]广东省英德市人民医院内镜中心,广东英德513000

出　　处：《中国医药科学》2019年第3期200-202,244,共4页China Medicine And Pharmacy

摘　　要：目的探讨内镜下窄带成像结合卢戈氏液染色对食管早期癌及癌前病变的诊断价值。方法将2014年1月～2018年5月在我院内镜中心作常规白光胃镜检查发现可疑食管病变者的58例作为研究对象,分别进行NBI以及卢戈氏液染色检查,并对病灶进行活检,统计单用NBl、卢戈氏液染色及NBI联合卢戈氏液染色对早期食管癌及癌前病变(癌前病变包括轻、中、重度不典型增生)检出率,比较三组的检查结果。结果 NBl组、卢戈氏液染色组和NBI联合卢戈氏液染色组使用对早期食管癌及癌前病变(癌前病变包括轻、中、重度不典型增生)检出率分别为20.7%(12/58)、24.1%(14/58)、32.8%(19/58);NBI联合卢戈氏液染色组与NBl组、卢戈氏液染色组比较,差异有统计学意义(P <0.05);NBl组与卢戈氏液染色组比较,差异无统计学意义(P> 0.05);三组炎症检出率相当,差异无统计学意义(P> 0.05),但NBI联合卢戈氏液染色组漏诊率明显低于NBl组、卢戈氏液染色组,差异有统计学意义(P <0.05)。结论内镜下窄带成像结合卢戈氏液染色对食管早期癌及癌前病变的诊断价值较高,能够指导内镜下早期食管癌切除范围,且操作简便,具有积极的临床意义。Objective To investigate the diagnostic value of narrow-band endoscopic imaging combined with lugol's fluid staining for early esophageal cancer and precancerous lesions. Methods Fifty-eight patients with suspected esophageal lesions detected by routine white-light gastroscopy in endoscopy center of our hospital from January 2014 to May 2018 were studied,the detection rates of early esophageal cancer and precancerous lesions (precancerous lesions including mild,moderate and severe atypical hyperplasia) by NBI and Lugol's solution staining alone and NBI combined with Lugol's solution staining were compared among the three groups. Results The detection rates of early esophageal cancer and precancerous lesions (precancerous lesions including mild, moderate and severe atypical hyperplasia) by NBI and Lugol's solution staining alone and NBI combined with Lugol's solution staining group were 20.7%(12/58),24.1%(14/58) and 32.8%(19/58),respectively.NBI combined with Lugol's solution staining group was compared with NBl group and Lugol's solution staining group,the difference was significant (P < 0.05);NBl group and lugo's solution staining group were compared,there was no significant difference (P > 0.05);The detection rate of inflammation in the three groups was similar,there was no significant difference (P > 0.05);However,the missed diagnosis rate of NBI combined with Lugol's staining group was significantly lower than that of NBl group and Lugol's staining group,the difference was statistically significant (P < 0.05). Conclusion Endoscopic narrow-band imaging combined with Lugol's staining has a high diagnostic value for early esophageal cancer and precancerous lesions,it can guide the scope of endoscopic early esophageal cancer resection,and it is easy to operate and has positive clinical significance.

关 键 词：食管早期癌及癌前病变 内镜下窄带成像(NBI) 卢戈氏液染色 诊断价值 

分 类 号：R735.1[医药卫生—肿瘤]