【摘要】 目的探讨内镜下美蓝染色对胃黏膜不典型病变中早期胃癌及其癌前病变的诊断价值。方法将326例胃黏膜表现不典型的成人患者随机分成染色内镜组和普通内镜组,分别在病变部位活检送病理组织学检查。结果染色内镜组166例患者中,60例胃黏膜上皮有肠化、50例上皮呈轻度-中度不典型增生、8例为重度不典型增生、8例为早期胃癌且经手术及术后病理证实病灶仅限于黏膜层且无淋巴结转移。普通内镜组160例,病理检查结果为伴有肠上皮化生40例、轻-中度不典型增生20例、重度不典型增生2例,无早期胃癌。染色内镜组早癌及癌前病变总检出率为75.9%,其中早期胃癌检出率为12.1%,均明显高于普通内镜组。结论内镜下美蓝染色指导活检可提高胃黏膜不典型增生和早期胃癌的检出率。更多还原

【Abstract】 Objective To explore the diagnostic value of chromoendoscopy in early gastric cancer and precancerous lesions. Methods Three hundred and twenty-six patients were divided into the chromoendoscopic group (166 cases) and the control group (160 cases). Biopsy specimens were taken from each patient during chromoendoscopy or normal endoscopy to confirm the histological features. Results In chromoendoscopic group, 60 patients had gastric intestinal metaplasia, 50 patients had mild to moderate atypical hyperplasia, 8 patients had severe atypical hyperplasia, 8 patients had early gastric cancer. In control group, 40 patients had gasytic intestinal metaplasia, 20 patients had mild to moderate atypical hyperplasia, 2 patients had severe atypical hyperplasia, and no patients had early gastric cancer. The detection rates of precancerous lesion and early gastric cancer were 75.9% and 12.1% respectively, which were higher than that in control group. Conclusions The endoscopic methylene blue test may be useful in diagnosis of early gastric cancer and precancerous lesions where visual signs of abnormality are indistinct or absent.更多还原