卢戈液-美蓝双重染色在早期食管癌诊断中的价值  

Evaluation of double vital staining with iodine and methylene blue in diagnosing early esophageal car-cinoma

作　　者：彭贵勇[1] 房殿春[1] 赵京晶[1] 李向红[1] 

机构地区：[1]第三军医大学西南医院全军消化专科中心,重庆400038

出　　处：《中华消化内镜杂志》2003年第6期374-376,共3页Chinese Journal of Digestive Endoscopy

摘　　要：目的 提高早期食管癌的诊断水平。方法 先用卢戈液染色,再用美蓝染色,比较2次染色后食管病灶着色及范围,大致判断浸润深度,并用超声小探头观察病灶侵犯深度,采用内镜下黏膜切除术和手术治疗。结果 10例患者共11处癌灶,卢戈液染色后 9处较好地显示了病灶范围,表现为正常食管黏膜染为棕色,病灶不着色;加用美蓝染色后,11处均清楚地显示了病灶,表现为正常黏膜不染色,病灶黏膜为水蓝色,边界清晰。1例行内镜下食管黏膜切除术切除,8例手术切除。病理结果均为鳞状细胞癌,其中黏膜癌6处,黏膜下癌4处,与其对照,胃镜和超声小探头鉴别黏膜癌和黏膜下癌的准确率均为80％,两者联合的准确率为90％。结论 卢戈液-美蓝染色较单一卢戈液染色,显示早期食管癌病灶及其范围更加清楚,可较准确地判断早期癌的侵犯深度。Objective To evaluate the value of double vital staining with both iodine and methylene blue in diagnosing early esophageal carcinoma. Methods Lugol' s iodine was sprayed on the esophageal lesions first, then methylene blue. The results before or after staining with mythylene blue were compared. The tumor infiltrative depth in the esophagus was assessed by gastric endoscopy and endoscopic ultrasonography (EUS). The tumors were resected surgically or under endoscopy. Results After Lugol's iodine spray it stained the normal esophageal squamous epithelium brown-black, whereas the lesions did not. In 10 cases with 11 lesions, 9 cases (81. 8% ) showed the margin of lesions fairly clear. After spray of methylene blue it stained all the lesions in blue color with clear margin. The mucosal resection was done in one case under endoscopy and surgical resection in 8 cases. All of the 9 cases were diagnosed pathologically squamus carcinoma including mucosal carcinoma, 6 lesions and submucosal carcinoma, 4 lesions. The pathological diagnostic accuracy in differentiating mucosal cancer from submucosal cancer by endoscopy or EUS was 80% ; by both endoscopy and EUS in conjunction was 90%. Conclusion Double vital staining with both iodine and methylene blue is very useful in revealing the area and infiltrative depth of early esophageal cancer.

关 键 词：卢戈液-美蓝双重染色 食管癌 诊断 黏膜 内窥镜超声检查 

分 类 号：R735.1[医药卫生—肿瘤]