国际肿瘤学杂志

国际肿瘤学杂志 ›› 2015, Vol. 42 ›› Issue (10): 734-737.doi: 10.3760/cma.j.issn.1673-422X.2015.10.004

• 论著 • 上一篇    下一篇

内镜下卢戈液染色联合窄带成像对食管癌及癌前病变的诊断分析

杨彬, 陈滟   

  1. 629000 四川省遂宁市中心医院消化内镜室（杨彬），口腔科（陈滟）
  • 出版日期:2015-10-08 发布日期:2015-09-08
  • 通讯作者: 杨彬 E-mail:chenyan201304@126.com

Diagnostic analysis of endoscopic Lugol solution staining combined with narrow band imaging for esophageal cancer and precancerous lesions

Yang Bin, Chen Yan   

  1. Department of Digestive Endoscopy, Suining Central Hospital of Sichuan Province, Suining 629000, China
  • Online:2015-10-08 Published:2015-09-08
  • Contact: Yang Bin E-mail:chenyan201304@126.com

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摘要： 目的 探讨内镜下卢戈液染色联合窄带成像(NBI)对食管癌及癌前病变的诊断价值。方法 选择2013年12月至2014年12月在四川省遂宁市中心医院行胃镜检查,存在可疑食管病灶而进行卢戈液染色和病理学检查的187例患者作为对照组，选择2015年1月至2015年6月行胃镜检查，存在可疑食管病灶而进行卢戈液染色联合NBI检查和病理学检查的124例患者作为观察组。对两组检查的敏感性、特异性和准确性进行比较。结果 观察组患者内镜下检测阳性率为75.0%，高于对照组的55.6%，差异有统计学意义 (χ2=12.07，P<0.01)。观察组患者的食管癌和高级别内瘤变检出率分别为29.0%和17.7%，均高于对照组的18.2%和6.4%，且差异有统计学意义(χ2= 4.15，P=0.04；χ2=8.54，P<0.01)。观察组患者内镜下检测结果与病理学检查结果的Kappa值=0.55，对照组患者的Kappa值=0.36。观察组检测方法的敏感性和准确性分别为89.9%和82.3%，高于对照组的71.8%和68.4%，且差异均有统计学意义(χ2=9.79，P<0.01；χ2=7.38，P<0.01)。 结论 卢戈液染色联合NBI对食管癌和食管癌前病变检测的敏感性和检出率优于单纯性卢戈液染色方法，值得在早期食管癌及癌前病变诊断中进行推广。

关键词: 内窥镜检查, 消化系统, 病理学, 临床, 食管肿瘤, 卢戈液染色

Abstract: Objective To investigate the diagnostic value of Lugol solution staining combined with narrow band imaging (NBI) for esophageal cancer and precancerous lesions. Methods From December 2013 to December 2014, 187 patients who were with suspicious esophageal lesions and stained with Lugol solution under endoscopy were selected as control group, while from January 2015 to June 2015, 124 patients who were with suspicious esophageal lesions and examined with Lugol solution staining and NBI under endoscopy were selected as observation group. The sensitivity, specificity and accuracy between the two groups were compared and analyzed. Results One hundred and four cases (75.0%) were found among observation group, which was higher than 93 cases (55.6%) among control group (χ2=12.07, P<0.01). The total detection rates of esophageal cancer and high grade intraepithelial neoplasia (HGN) were 29.0% and 17.7% in observation group respectively, which were higher than 18.2% and 6.4% in control group (χ2= 4.15, P=0.04; χ2=8.54, P<0.01). The Kappa value in observation group was 0.55, which was higher than 0.36 in control group. The sensitivity and accuracy in observation group were 89.9% and 82.3% respectively, which were significantly higher than 71.8% and 68.4% in control group (χ2=9.79, P<0.01; χ2=7.38, P<0.01). Conclusion The sensitivity and accuracy of endoscopic Lugol solution staining combined with NBI for esophageal cancer and precancerous lesions are higher than Lugol solution staining, and it is worthy to popularize the application of Lugol solution staining combined with NBI in diagnosing esophageal cancer and precancerous lesions.

Key words: Endoscopy, digestive system, Pathology, clinical, Esophageal neoplasms, Lugol solution staining