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目的:探讨内镜下醋酸联合靛胭脂染色对胃黏膜平坦型病变的临床辅助诊断价值。方法:就诊患者行常规内镜检查,有胃黏膜平坦型病变者随机分为2组,染色组行内镜下醋酸联合靛胭脂染色后活检;对照组不染色,肉眼判断病灶,常规活检。结果:共入选240例,染色组和对照组各120例。染色组中18例出现喷洒染色剂后黏膜退色,其早期胃癌、高级别上皮内瘤变发现率之和为94.4%(17/18);79例出现喷洒染色剂后黏膜着色不良,其肠上皮化生、低级别上皮内瘤变的发现率之和为91.1%(72/79)。染色组共检出早期胃癌10例(8.3%)、上皮内瘤变25例(20.8%)、肠上皮化生58例(48.3%);对照组共检出早期胃癌2例(1.7%)、上皮内瘤变6例(5.0%)、肠上皮化生32例(26.7%)。结论:内镜下醋酸联合靛胭脂染色可提高胃平坦型病变患者早期胃癌及癌前病变的发现率,黏膜退色对于早期胃癌和高级别上皮内瘤变、黏膜着色不良对于肠上皮化生和低级别上皮内瘤变的诊断有一定的指示意义。
Objective: To investigate the clinical value of endoscopic acetic acid combined with indigo rouge in the diagnosis of gastric mucosal flat lesions. Methods: The patients underwent routine endoscopy. Patients with flat lesions of gastric mucosa were randomly divided into 2 groups. The staining group was endoscopically stained with acetic acid followed by indigo carmine staining. The control group was not stained, the lesion was visualized by the naked eye, and the routine biopsy was performed. Results: A total of 240 cases were enrolled, 120 cases in the staining group and the control group. In the staining group, mucosal fade was observed in 18 of the 18 cases (94.4%, 17/18) after spraying the dye. The smear of 79 cases appeared poor coloration of the mucosa, the intestinal epithelium The combined rates of metaplasia and low-grade intraepithelial neoplasia were 91.1% (72/79). In the staining group, 10 cases (8.3%) of early gastric cancer, 25 (20.8%) cases of intraepithelial neoplasia and 58 (48.3%) of intestinal metaplasia were detected in the staining group, 2 cases (1.7% Intraepithelial neoplasia in 6 cases (5.0%), intestinal metaplasia in 32 cases (26.7%). Conclusion: Endoscopic acetic acid combined with indigo rouge staining can improve the early gastric cancer and precancerous lesions in patients with gastric flat lesions, mucosal fade for early gastric cancer and high grade intraepithelial neoplasia, poor mucosal staining for intestinal metaplasia and low Level of intraepithelial neoplasia diagnosis has some indication.