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目的:探讨亚甲蓝色素内镜对诊断胃癌前病变和鉴别良、恶性胃溃疡的价值。方法:对13例内镜下胃溃疡样表现者口服亚甲蓝0.15,4～6h后观察溃疡的内镜下特点,并在染色部位取活检送病理组织学检查;对23例内镜下胃黏膜异常表现者(包括5例胃溃疡样表现者)局部用0.5%亚甲蓝均匀喷洒,在染色部位取活检送病理组织学检查。结果:21例存在肠化生和不典型增生;2例为恶性胃溃疡,均经手术及病理证实病灶局限于黏膜和黏膜下层,为早期胃癌。结论:亚甲蓝色素内镜可提高胃癌前病变的检出率,对良、恶性胃溃疡有鉴别诊断价值。
Objective: To explore the value of methylene blue endoscopy in the diagnosis of gastric precancerous lesions and the identification of benign and malignant gastric ulcer. Methods: Thirteen patients with endoscopic gastric ulcer-like performance were treated with oral methylene blue for 0.15,4 to 6 hours. The endoscopic features of the ulcer were observed and biopsied in the stained sections for pathological examination. Mucosal abnormalities (including 5 cases of gastric ulcer-like performance) locally with 0.5% methylene blue spray evenly, biopsy in the staining site for histopathological examination. Results: There were 21 cases of intestinal metaplasia and dysplasia; 2 cases of malignant gastric ulcer, both confirmed by surgery and pathology confined to the mucosa and submucosa lesions, early gastric cancer. Conclusion: Methylene blue pigment endoscopy can improve the detection rate of gastric precancerous lesions, with differential diagnosis of benign and malignant gastric ulcer.