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目的探讨内镜下卢戈液染色和活检组织 P53检测诊断食管早期癌和癌前病变的可行性。方法 78例可疑早期食管癌患者行内镜下卢戈液染色,对粘膜不染色区活检结果为重度不典型增生细胞者行 P53蛋白免疫组化染色,对 P53蛋白阳性的病灶行内镜粘膜切除术。结果在 78例患者中,共发现 25例患者存在 31处粘膜不染色区,其中单纯增生上皮 1处,轻度异型增生 2处,中度异型增生 9处,重度异型增生 16处,鳞状细胞癌 3处。 7例 P53蛋白表达阳性的重度不典型增生粘膜行内镜粘膜切除术后, 1例被证实为粘膜内癌。结论卢戈液染色和活组织 P53蛋白检测不仅对诊断早期食管癌有帮助,而且对选择治疗重度不典型增生病灶行内镜粘膜切除术有指导意义。
Objective To investigate the feasibility of endoscopic Lugo’s staining and biopsy of P53 in the diagnosis of early esophageal cancer and precancerous lesions. Methods Eighty-seven suspicious early esophageal cancer patients underwent endoscopic Lugol’s staining. P53 protein immunohistochemical staining was performed on mucosal non-stained area biopsy for severe dysplasia. Endoscopic mucosal resection was performed on P53 positive lesions. Surgery. RESULTS: Of the 78 patients, a total of 31 mucosal non-stained areas were found in 25 patients, including 1 hyperplastic epithelium, 2 mild dysplasias, 9 moderate dysplasias, 16 severe dysplasias, and squamous cells. There are 3 cancers. Seven cases of severe atypical hyperplasia with P53 protein expression were treated with endoscopic mucosal resection. One case was confirmed as intramucosal carcinoma. Conclusions Lugo’s fluid staining and biopsy P53 protein detection are not only helpful for the diagnosis of early esophageal cancer, but also have guiding significance for the selection of endoscopic resection of severe dysplasia lesions.