殷桂香 王贞彪 乔进朋 鲁力峰 王晓燕

    [摘要] 目的: 探讨双重染色内镜在消化道早癌中的诊断价值。方法：选取2009年1月~2010年12月间在丰台医院消化内镜中心进行胃肠镜检查的患者1 880例，分为观察组(406例)和对照组(1 474例)，其中观察组进行内镜下醋酸-卢戈碘液、醋酸-美兰的双重染色，并行病理检查；对照组采取经验性活检取材病理检查，观察两组差异性。结果：观察组中，食管黏膜染色213例，总检出率为15.5%，早癌4例，中重度非典型增生及食管早癌检出率为8.0%；对照组588例，总检出率3.1%，中重度非典型增生及食管早癌检出率为1.2%，两组比较差异有高度统计学意义(P<0.01)；观察组胃黏膜染色109例，总检出率66.1%，早癌7例，中重度非典型增生及早期胃癌检出率为24.8%，对照组548例，总检出率8.6%，中重度非典型增生及早期胃癌检出率为1.6%，两组比较差异有高度统计学意义(P<0.01)；观察组肠黏膜染色84例，总检出率79.8%，早癌1例，中重度非典型增生及结直肠早癌检出率为10.7%，对照组338例，总检出率19.8%，中重度非典型增生及结直肠早癌检出率为0.6%，两组比较差异有高度统计学意义(P<0.01)。结论：内镜下醋酸-卢戈碘液、醋酸-美兰的双重染色法可提高消化道早癌及癌前病变的检出率，具有较高应用价值。

    [关键词] 色素内镜；早癌；消化道

    [中图分类号] R735 [文献标识码]B[文章编号]1673-7210(2011)11(c)-186-03

    Important value of double staining endoscopy in diagnosis of early digestive tract cancer

    YIN Guixiang1, WANG Zhenbiao2*, QIAO Jinpeng1, LU Lifeng1, WANG Xiaoyan1

    1.Department of Gastroenterology, Beijing Fengtai Hospital, Beijng100071, China;2.Department of Gastroenterology, Beijing You'an Hospital Affiliated to Capital University, Beijing100069, China

    [Abstract] Objective: To investigate the value of double staining endoscopy in the diagnosis of early digestive tract cancer. Methods: 1 880 patients who had received gastrointestinal endoscopy examination in the digestive endoscopy center of Fengtai hospital from January 2009 to December 2010 were selected and divided into the observation group (406 patients) and the control group (1 474 patients). The observation group received the endoscopic double staining of acetic acid-Lugol's iodine solution and acetic acid-methylene blue and parallel pathological examination, while the control group received empirical biopsy pathological examination. The differences between the two groups were observed. Results: In the observation group, there were 213 patients with esophageal mucosal staining and the total detection rate was 15.5%. There were 4 patients with early cancer and the detection rate of moderate and severe atypical hyperplasia and esophageal early cancer was 8.0%. In the control group, there were 588 patients with esophageal mucosal staining and the total detection rate was 3.1%. The detection rate of moderate and severe atypical hyperplasia and esophageal early cancer was 1.2%. There were significant differences between the observation group and the control group (P<0.01). In the observation group, there were 109 patients with gastric mucosal staining and the total detection rate was 66.1%. There were 7 patients with early cancer and the detection rate of moderate and severe atypical hyperplasia and early gastric cancer was 24.8%. In the control group, there were 548 patients with gastric mucosal staining and the total detection rate was 8.6%. The detection rate of moderate and severe atypical hyperplasia and early gastric cancer was 1.6%. There were significant differences between the observation group and the control group (P<0.01). In the observation group, there were 84 patients with intestinal mucosal staining and the total detection rate was 79.8%. There was 1 patient with early cancer and the detection rate of moderate and severe atypical hyperplasia and colon and rectal early cancer was 10.7%. In the control group, there were 338 patients with intestinal mucosal staining and the total detection rate was 19.8%. The detection rate of moderate and severe atypical hyperplasia and colon and rectal early cancer was 0.6%. There were significant differences between the observation group and the control group (P<0.01). Conclusion: The endoscopic double staining of acetic acid-Lugol's iodine solution and acetic acid-methylene blue can improve the detection rate of digestive tract early cancer and precancerosis, thereby of high application value. ......