摘要
目的探讨内镜下卢戈液染色联合超声微探头在早期食管癌及癌前病变中的诊治价值。方法对36例常规胃镜下表现为食管黏膜粗糙、糜烂、颜色异常、微隆起或浅凹等可疑病变者行内镜下卢戈液染色,病理分别为食管炎6例,食管不典型增生20例(轻度6例,中度4例,高度10例),食管癌10例,对26例活检病理为食管炎及不典型增生患者在卢戈液不染区或淡染区再次活检。结果 14例食管癌及12例食管高度不典型增生患者接受超声内镜检查;最终9例食管癌、10例高度不典型增生患者行内镜下黏膜剥离术(ESD)或内镜下黏膜切除术(EMR),7例行手术治疗。26例异常患者超声微探头检查示:14例食管癌患者中T1期10例(累及黏膜及黏膜肌层8例,黏膜下层2例),T2期4例;12例高级别瘤变患者中累及黏膜层9例,黏膜下层2例,固有肌层1例;与术后病理比较,EUS对浸润深度判断准确率食管癌组为78.6%(11/14),高度不典型增生组为83.3%(10/12),诊断准确率为80.8%(21/26)。19例ESD及EMR中发现切缘累及1例,基底部累及1例。结论卢戈液染色及指导下活检可提高食管早癌及癌前病变的检出率,为内镜下治疗明确病变范围,联合超声微探头可为食管癌及癌前病变治疗及方式选择提供重要依据。
[ Objective ] To investigate clinic value of endoscopic Lugol＇s stain combined with miniprobe sonography in early esophageal cancer and precancerous lesions. [ Method ] 36 cases with doubtful esophageal diseases who were pathologically diagnosed as chronic inflammation （6 cases）, dysplasia （20 cases）, and esophageal cancer （10 cases） were enrolled. Lugol＇s iodine was sprayed on the esophageal lesions. Biopsies were taken from unstained and light yellow areas for 26 cases who were pathologically diagnosed as chronic inflammation and dysplasia. [ Results ] Endoscopic ultrasound examination was performed in 14 cases of esophageal carcinoma and 12 cases of severe dysplasia. Finally 9 cases of esophageal carcinoma and 10 cases of severe dysplasia patients were performed by ESD or EMR, 7 cases accepted oper- ation therapy. The examination of miniprobe sonography to 26 abnormal patients shows that there were 10 cases in T1 from 14 patients who suffered from esophageal carcinoma, and 4 cases are in T2. There were 9 cases who are involved in mucosa in the 12 advanced dysplasia patients. In addition, there were two cases of submueosa, one case of muscularis propria. Compared with postnperative pathology, the accuracy rate of EUS on the depth of invasion diagnosis was 78.6% （11/14） in the esophageal cancer group, and 83.3% （10/12） was for highly atypical hyperplasia group, the accurate diag- nosis rate was 80.8% （21/26）. [ Conclusion ] Lugol＇s stain and guided biopsy can increase the detection rate of the early esophagus carcinoma and precancerous lesion, which confines the endoscopic treatment of the lesion area, combined with miniprobe sonography can provide some important evidences for treatment selection of the esophageal cancer and pre- cancerous lesions.
出处
《中国内镜杂志》
CSCD
北大核心
2013年第9期919-922,共4页
China Journal of Endoscopy
关键词
卢戈液
超声内镜
食管癌
癌前病变
Lugol＇ s solution
endosonography
early esophageal cancer
precancerous lesions
