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目的 提高早期食管癌的诊断水平。方法 先用卢戈液染色,再用美蓝染色,比较2次染色后食管病灶着色及范围,大致判断浸润深度,并用超声小探头观察病灶侵犯深度,采用内镜下黏膜切除术和手术治疗。结果 10例患者共11处癌灶,卢戈液染色后 9处较好地显示了病灶范围,表现为正常食管黏膜染为棕色,病灶不着色;加用美蓝染色后,11处均清楚地显示了病灶,表现为正常黏膜不染色,病灶黏膜为水蓝色,边界清晰。1例行内镜下食管黏膜切除术切除,8例手术切除。病理结果均为鳞状细胞癌,其中黏膜癌6处,黏膜下癌4处,与其对照,胃镜和超声小探头鉴别黏膜癌和黏膜下癌的准确率均为80％,两者联合的准确率为90％。结论 卢戈液-美蓝染色较单一卢戈液染色,显示早期食管癌病灶及其范围更加清楚,可较准确地判断早期癌的侵犯深度。
Objective To improve the diagnosis of early esophageal cancer. Methods The Lugol’s fluid was first used to stain and then the methylene blue stain was used to compare the staining and extent of esophageal lesions after 2 stained smears to determine the depth of invasion. The depth of lesion was observed with a small ultrasound probe. Endoscopic mucosal resection and surgical treatment were performed. Results A total of 11 foci of 10 patients were obtained. After the Lugol’s solution was stained, the extent of the lesion was better displayed at 9, which showed that the normal esophageal mucosa was stained brown and the lesion was not stained. After using methylene blue stained, Shows lesions, showing normal mucosa is not stained, focal mucosa is aqua blue, the boundary is clear. A case of endoscopic esophagectomy resection, 8 cases of surgical resection. Pathological findings were squamous cell carcinoma, mucosal carcinoma in which 6, 4 submucosal cancer, compared with the control, gastroscopy and ultrasound probe to identify mucosal cancer and submucosal cancer were 80% accuracy, the accuracy of the combination of the two Is 90%. Conclusions Lugol’s liquid-methylene blue staining is more effective than single Lugol’s staining in diagnosing early esophageal cancer lesions and its range, which can accurately determine the invasion depth of early cancer.