【摘要】 目的观察不同的染色方法对内镜检出Barrett食管(BE)的影响。方法对101例胃镜检查中怀疑BE食管的病人,随机分为单染组和双染组,在胃镜下分别用复方碘溶液(单染组)或复方碘溶液-美蓝(双染组)在食管下段进行染色,单染组在GEJ以上不着色的柱状上皮区即可疑BE上皮区,按四象限活检方法多点取活检送病理学检查;双染组未着色者按四象限活检方法在GEJ以上不染区取材,着色病例在蓝染区多点取材送组织病理学检查。结果单染组各种病理类型的BE(即柱状上皮)均不着色,正常食管黏膜(即鳞状上皮)呈棕色;双染组特殊肠化型BE着蓝色,贲门型及胃底型BE仍然不着色。双染组肠化型BE的检出率为22.45%,而单染组肠化型BE的检出率为7.84%。双重染色中蓝染区诊断肠化型BE的敏感性84.62%,特异性94.74%,未着色区未检出肠化型BE。结论胃镜下用复方碘溶液-美蓝双重染色,采取"靶点活检",提高了BE食管肠化型的检出率。更多还原

【Abstract】 Objective To investigate the diagnostic value of Barrett’s esophagus using different staining technique under endoscope.Methods 101 patients with suspected Barrett’s esophagus under endoscope were observed,among them 49 patients were stained with Lugol’s solution(single staining group),while 51 patients were stained with Lugol’s solution-methylene blue under endoscopy(double staining group),and then underwent biopsy.In single staining group biopsy specimens obtained from unstained areas according to 4 random quadrant biopsies(4QB).In double staining group,unstained areas according to(4QB),stained areas were targeted from blue areas.Results In single staining group the normal esophageal squamous epithelium were brown-black stained;all type Barrett’s esophagus(columnar-appearing mucosa) did not stained.In double staining group,BE of gastric fundic type and cardiac type were unstained,specialized intestinal metaplasia in Barrett’s esophagus were blue stained,and there were no intestinal metaplasia detected in unstained area.The prevalence rate of specialized intestinal metaplasia was 22.45% in Lugol’s solution-methylene blue staining group,while the Lugol’s solution group was 7.84%.The sensitivity and specificity for detection of specialized intestinal metaplasia in stained areas were 84.62% and 94.74%.Conclusion The Lugol’s solution-methylene blue staining significantly increases the detection of specialized intestinal metaplasia in Barrett’s esophagus.更多还原