醋酸联合靛胭脂染色在胃黏膜肠上皮化生随访监测中的价值

发布时间：2018-04-14 17:28

本文选题：醋酸 + 靛胭脂　；参考：《中国内镜杂志》2015年06期

【摘要】：目的探讨内镜下醋酸联合靛胭脂染色在胃黏膜肠上皮化生随访监测中的价值。方法纳入在该院内镜中心行随访的胃黏膜肠上皮化生患者共52例,普通胃镜下观察胃黏膜形态后行醋酸联合靛胭脂染色,分别在染色后黏膜着色不良区、周围染色正常区、普通胃镜下可疑病灶以及周围正常区各活检2块,行组织病理学检查。结果染色后52例均出现局部黏膜着色不良,在黏膜着色不良区活检的104份组织标本,其中90份标本提示有肠上皮化生,14份标本提示慢性炎症;周围染色正常区活检的104份组织标本中,4份标本提示有肠上皮化生,100份标本提示慢性炎症。普通胃镜下可疑病灶活检的104份组织标本,其中64份标本提示有肠上皮化生,40份标本提示慢性炎症;周围正常区活检的104份组织标本中,6份标本提示有肠上皮化生,98份标本提示慢性炎。染色胃镜诊断肠上皮化生的敏感性为88.5%(46/52)、特异性为50%(3/6)、阳性预测值为86.5%(90/104)及阴性预测值为96.2%(100/104);而普通胃镜分别为:69.2%(36/52)、18.8%(3/16)、61.5%(64/104)及94.2%(98/104)。染色胃镜诊断肠上皮化生的敏感性和阳性预测值均较普通胃镜高,差异有显著性(分别为P=0.016和P0.001)。结论内镜下醋酸联合靛胭脂染色有助于提高肠上皮化生的靶向活检阳性率。
[Abstract]:Objective to investigate the value of endoscopic acetic acid combined with indigo carmine staining in monitoring intestinal metaplasia of gastric mucosa.Methods 52 cases of intestinal metaplasia of gastric mucosa were followed up in the endoscopic center of our hospital. The morphology of gastric mucosa was observed with acetic acid combined with indigo rouge staining under general gastroscopy.Pathological examination was performed on 2 suspicious lesions and 2 adjacent normal areas under general gastroscopy.Results Local mucosal dyschromism was found in all 52 cases after staining. 104 tissue specimens were biopsy in the dyschromatic area of mucous membrane, of which 90 specimens suggested chronic inflammation with 14 specimens of intestinal metaplasia.Four of 104 biopsy specimens in the normal stained area suggested chronic inflammation in 100 specimens of intestinal metaplasia.104 biopsy specimens of suspected lesions were examined under general gastroscopy, of which 64 specimens suggested chronic inflammation with 40 specimens of intestinal metaplasia.Of 104 tissue specimens from peripheral normal area biopsy, 6 specimens suggested chronic inflammation in 98 specimens of intestinal metaplasia.The sensitivity of staining gastroscopy in the diagnosis of intestinal metaplasia was 88.5 / 52, the specificity was 50 / 3 / 6, the positive predictive value was 86.5 / 90 / 104) and the negative predictive value was 96.22or 100 / 104; and the common gastroscope was respectively 30 / 69.236 / 5218.8 / 18.8 / 3161.5 / 61.5 / 64 / 104 and 94.29898 / 104 / 104 respectively.The sensitivity and positive predictive value of staining gastroscopy in the diagnosis of intestinal metaplasia were significantly higher than those in common gastroscopy (P 0. 016 and P 0. 001 respectively).Conclusion Endoscopic acetic acid combined with indigo carmine staining can improve the positive rate of targeted biopsy of intestinal metaplasia.
【作者单位】：江苏省靖江市人民医院消化科;
【基金】：泰州市科技发展计划资助项目(2012) 泰州市第四期“311高层次人才培养工程”资助项目(2012)
【分类号】：R573

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