内镜下碘染色用于江苏淮安地区食管疾病筛查1983例研究
|
摘要
目的探讨内镜下碘染色在食管癌高发区的食管早癌内镜筛查中的重要临床价值。方法 2014至2016年在江苏省淮安市清浦区武墩镇及盐河镇等对1983例40～60岁人群进行食管癌内镜筛查,对比碘染色前后食管黏膜颜色和形态的变化,并对黏膜染色异常者行活检病理检查。结果 740例患者共835处病灶接受食管组织活检,有273例于碘染色前发现(白光状态下),碘染色后再发现562例。其中碘染后新发现5例黏膜内癌,205例各种异型增生,2组比较差异有统计学意义(P<0.05),表明碘染色后食管癌及癌前病变的检出率明显高于染色前。结论内镜下食管黏膜碘染色可明显提高筛查过程中食管癌及癌前病变的检出率,且因其价格低廉,操作简单,值得临床推广应用。
Objective To investigate the important clinical value of endoscopic iodine staining in endoscopic screening of esophageal early cancer in high incidence area of esophageal cancer.Methods Endoscopic esophageal cancer screening was performed on 1 983 patients aged 40-60 years in Wudun Town and Yanhe Town,Qingpu District,Huai′an City of Jiangsu Province.The color and morphology of esophageal mucosa were compared before and after iodine staining,and biopsy was performed on abnormal mucosa staining.Results A total of 835 lesions in 740 patients underwent esophageal biopsy,273 were found before iodine staining(white light),and 562 were found after iodine staining.Among them,5 cases of intramucosal carcinoma and 205 cases of dysplasia were found after iodine staining.The difference between the two groups was statistically significant(P<0.05),which indicated that the detection rate of esophageal cancer and precancerous lesions after iodine staining was significantly higher than that before staining.Conclusion Endoscopic iodine staining of esophageal mucosa can significantly improve the detection rate of esophageal cancer and precancerous lesions during screening.Because of its low price and simple operation,it is worthy of clinical application.
Objective To investigate the important clinical value of endoscopic iodine staining in endoscopic screening of esophageal early cancer in high incidence area of esophageal cancer.Methods Endoscopic esophageal cancer screening was performed on 1 983 patients aged 40-60 years in Wudun Town and Yanhe Town,Qingpu District,Huai′an City of Jiangsu Province.The color and morphology of esophageal mucosa were compared before and after iodine staining,and biopsy was performed on abnormal mucosa staining.Results A total of 835 lesions in 740 patients underwent esophageal biopsy,273 were found before iodine staining(white light),and 562 were found after iodine staining.Among them,5 cases of intramucosal carcinoma and 205 cases of dysplasia were found after iodine staining.The difference between the two groups was statistically significant(P<0.05),which indicated that the detection rate of esophageal cancer and precancerous lesions after iodine staining was significantly higher than that before staining.Conclusion Endoscopic iodine staining of esophageal mucosa can significantly improve the detection rate of esophageal cancer and precancerous lesions during screening.Because of its low price and simple operation,it is worthy of clinical application.
引文
1 朱月,李志建,王欣欣,等.食管碘染异常病灶内镜活检及术后完整病理的对比分析[J].中华消化内镜杂志,2016,33(10):710-712.
2 Visrodia K,Iyer PG,Schleck CD,et al.Yield of Repeat Endoscopy in Barrett′s Esophagus with No Dysplasia and Low-Grade Dysplasia:A Population-Based Study[J].Dig Dis Sci,2016,61(1):158-167.
3 Lili L,Lihao Z,Baochai L,et al.Adjuvant Therapeutic Modalities Following Three-field Lymph Node Dissection for Stage II/III Esophageal Squamous Cell Carcinoma[J].J Cancer,2017,8(11):2051-2059.
4 Zhu H T,Ai D S,Tang H R,et al.Long-term results of paclitaxel plus cisplatin with concurrent radiotherapy for loco-regional esophageal squamous cell carcinoma[J].World J Gastroenterol,2017,23(3):540-546.
5 中华医学会消化内镜学分会消化系早癌内镜诊断与治疗协作组.中国早期食管鳞状细胞癌及癌前病变筛查与诊治共识(2015年,北京)[J].中华消化内镜杂志,2016,33(1):3-18.
6 李鹏,王拥军,陈光勇,等.中国早期食管鳞状细胞癌及癌前病变筛查与诊治共识(2015年·北京)[J].中国实用内科杂志,2016,55(1):17-31.
7 朱月,李志建,王欣欣,等.食管碘染异常病灶内镜活检及术后完整病理的对比分析[J].中华消化内镜杂志,2016,33(10):710-712.
8 永井薫子,野口剛.Organization of the mucous membrane in the human esophagus and stomach,with special references to the distribution of lymphatic vessels and cancer invasion[J].医学生物学電子顕微鏡技術学会誌,2015,28(2):8-13.
9 Protano MA,Xu H,Wang G,et al.Low-Cost High-Resolution Microendoscopy for the Detection of Esophageal Squamous Cell Neoplasia:An International Trial[J].Gastroenterology,2015,149(2):321-329.
10 尹成龙,徐芳媛,袁志萍,等.三种模式内镜检查诊断早期食管癌及癌前病变的对比研究[J/CD].中华消化病与影像杂志(电子版),2013,3(4):8-12.
11 赵九龙,杨帆,李兆申.早期食管癌及癌前病变的内镜下筛查和精查进展[J].中华消化内镜杂志,2015,32(5):338-340.
12 曾海龙,张正坤.放大内镜结合窄带成像技术对上消化道早期癌及癌前病变的诊断价值[J].中国临床研究,2016,29(4):452-455.
13 Wang HC,Nguyen NV,Lin RY,et al.Characterizing Esophageal Cancerous Cells at Different Stages Using the Dielectrophoretic Impedance Measurement Method in a Microchip[J].Sensors(Basel),2017,17(5).pii:E1053.
14 张惠晶,周环,矫太伟,等.窄带成像技术与碘染色诊断早期食管癌及其癌前病变的对比研究[J].中华消化内镜杂志,2016,33(1):33-36.
2 Visrodia K,Iyer PG,Schleck CD,et al.Yield of Repeat Endoscopy in Barrett′s Esophagus with No Dysplasia and Low-Grade Dysplasia:A Population-Based Study[J].Dig Dis Sci,2016,61(1):158-167.
3 Lili L,Lihao Z,Baochai L,et al.Adjuvant Therapeutic Modalities Following Three-field Lymph Node Dissection for Stage II/III Esophageal Squamous Cell Carcinoma[J].J Cancer,2017,8(11):2051-2059.
4 Zhu H T,Ai D S,Tang H R,et al.Long-term results of paclitaxel plus cisplatin with concurrent radiotherapy for loco-regional esophageal squamous cell carcinoma[J].World J Gastroenterol,2017,23(3):540-546.
5 中华医学会消化内镜学分会消化系早癌内镜诊断与治疗协作组.中国早期食管鳞状细胞癌及癌前病变筛查与诊治共识(2015年,北京)[J].中华消化内镜杂志,2016,33(1):3-18.
6 李鹏,王拥军,陈光勇,等.中国早期食管鳞状细胞癌及癌前病变筛查与诊治共识(2015年·北京)[J].中国实用内科杂志,2016,55(1):17-31.
7 朱月,李志建,王欣欣,等.食管碘染异常病灶内镜活检及术后完整病理的对比分析[J].中华消化内镜杂志,2016,33(10):710-712.
8 永井薫子,野口剛.Organization of the mucous membrane in the human esophagus and stomach,with special references to the distribution of lymphatic vessels and cancer invasion[J].医学生物学電子顕微鏡技術学会誌,2015,28(2):8-13.
9 Protano MA,Xu H,Wang G,et al.Low-Cost High-Resolution Microendoscopy for the Detection of Esophageal Squamous Cell Neoplasia:An International Trial[J].Gastroenterology,2015,149(2):321-329.
10 尹成龙,徐芳媛,袁志萍,等.三种模式内镜检查诊断早期食管癌及癌前病变的对比研究[J/CD].中华消化病与影像杂志(电子版),2013,3(4):8-12.
11 赵九龙,杨帆,李兆申.早期食管癌及癌前病变的内镜下筛查和精查进展[J].中华消化内镜杂志,2015,32(5):338-340.
12 曾海龙,张正坤.放大内镜结合窄带成像技术对上消化道早期癌及癌前病变的诊断价值[J].中国临床研究,2016,29(4):452-455.
13 Wang HC,Nguyen NV,Lin RY,et al.Characterizing Esophageal Cancerous Cells at Different Stages Using the Dielectrophoretic Impedance Measurement Method in a Microchip[J].Sensors(Basel),2017,17(5).pii:E1053.
14 张惠晶,周环,矫太伟,等.窄带成像技术与碘染色诊断早期食管癌及其癌前病变的对比研究[J].中华消化内镜杂志,2016,33(1):33-36.