放大镜OE模式联合卢戈氏染色模式在食管早癌及癌前病变诊断中的应用价值

中华养生保健 ›› 2023, Vol. 41 ›› Issue (4): 22-25.

放大镜OE模式联合卢戈氏染色模式在食管早癌及癌前病变诊断中的应用价值

徐彦玲¹, 时霞¹, 董磊², 刘志娟³, 厉乃菡¹

1.日照市中医医院脾胃病科,山东日照, 276800;
2.日照市中医医院内镜中心,山东日照, 276800;
3.日照市中医医院门诊部,山东日照, 276800

出版日期:2023-02-16 发布日期:2023-02-16
作者简介:徐彦玲（1974—）,女,汉族,籍贯：山东省日照市,本科,副主任医师,研究方向：消化内科临床及内镜下诊疗。

Application Value of Magnifying Glass OE Pattern Combined with Lugol's Staining Pattern in the Diagnosis of Early Esophageal Cancer and Precancerous Lesions

XU Yan-ling¹, SHI Xia¹, DONG Lei², LIU Zhi-juan³, LI Nai-han¹

1. Orthopaedics, Rizhao Hospital of Traditional Chinese Medicine, Rizhao Shandong, 276800, China;
2. Endoscopy Center, Rizhao Hospital of Traditional Chinese Medicine, Rizhao Shandong, 276800, China;
3. Outpatient department, Rizhao Hospital of Traditional Chinese Medicine, Rizhao Shandong, 276800, China

Online:2023-02-16 Published:2023-02-16

摘要/Abstract

摘要： 目的探讨放大镜OE模式联合卢戈氏染色模式在食管早癌及癌前病变诊断中应用价值。方法回顾性分析2019年11月—2021年11月日照市中医医院门诊接诊的40例疑似食管黏膜病变患者的临床资料。全部患者均采用电子胃镜进行内镜检查,分别在放大镜OE模式、卢戈氏染色模式下进行内镜检查,以病理检查结果为金标准,分析并对比放大镜OE模式及放大镜OE模式联合卢戈氏染色模式对食管早癌及癌前病变诊断的灵敏度、准确度、特异度、阴性预测值（NPV）、阳性预测值（PPV）,并分析放大镜OE模式、卢戈氏染色检测食管早癌及癌前病变情况与病理检查结果的关系。结果 40例疑似食管黏膜病变患者,经病理检查后,有28例确诊为食管早癌及癌前病变,其中食管早癌8例,轻度不典型增生10例,中度不典型增生6例,重度不典型增生4例;剩余12例为食管炎或糜烂或溃疡。其中放大镜OE模式检出阳性22例,放大镜OE模式联合卢戈氏染色模式检出阳性27例。联合检测诊断食管早癌及癌前病变的准确度、灵敏度高于放大镜OE模式单一检测,差异有统计学意义（P<0.05）;kappa检验显示,放大镜OE模式与病理诊断一致性尚可（kappa值=0.479,P=0.001）;联合检测与病理诊断一致性极好（kappa值=0.826,P<0.001）。结论放大镜OE模式联合卢戈氏染色模式检查诊断食管早癌及癌前病变的准确率、灵敏度更高,可为早期开展治疗提供重要参考。

关键词: 食管早癌, 癌前病变, 卢戈氏染色模式

Abstract: Objective To explore the application value of magnifying glass OE pattern combined with Lugol's staining pattern in the diagnosis of early esophageal cancer and precancerous lesions. Methods The clinical data of 40 patients with suspected esophageal mucosal lesions admitted to the outpatient clinic of Rizhao Hospital of Traditional Chinese Medicine from November 2019 to November 2021 were retrospectively analyzed. All patients underwent endoscopy with electronic gastroscope. Endoscopy was performed under the magnifying glass OE mode and Lugol's staining mode, respectively. The pathological examination results were used as the gold standard to analyze and compare the magnifying glass OE mode and the magnifying glass OE mode combined with Lugol's. The sensitivity, accuracy, specificity, negative predictive value (NPV), positive predictive value (PPV) of staining pattern for the diagnosis of early esophageal cancer and precancerous lesions, and analysis of magnifying glass OE pattern and Lugol's staining to detect early esophageal cancer and cancer The relationship between pre-lesion and pathological examination results. Results Among 40 patients with suspected esophageal mucosal lesions, 28 were diagnosed with early esophageal cancer and precancerous lesions after pathological examination, including 8 early esophageal cancer, 10 mild dysplasia,6 moderate dysplasia, and severe dysplasia. There were 4 cases of dysplasia; the remaining 12 cases were esophagitis or erosion or ulcer. Among them, 22 cases were positive in magnifying glass OE mode, and 27 cases were positive in magnifying glass OE mode combined with Lugol's staining mode. The accuracy and sensitivity of combined detection in the diagnosis of early esophageal cancer and precancerous lesions were higher than that of single detection with magnifying glass OE mode (P<0.05); Kappa test showed that the concordance between magnifying glass OE mode and pathological diagnosis was fair (Kappa value=0.479, P=0.001);the concordance between combined detection and pathological diagnosis was excellent (Kappa=0.826,P<0.001).ConclusionThe magnifying glass OE mode combined with Lugol's staining mode has higher accuracy and sensitivity in the diagnosis of early esophageal cancer and precancerous lesions,which can provide an important reference for early treatment.

Key words: early esophageal cancer, precancerous lesions, Lugol's staining pattern

中图分类号:

R735

徐彦玲, 时霞, 董磊, 刘志娟, 厉乃菡. 放大镜OE模式联合卢戈氏染色模式在食管早癌及癌前病变诊断中的应用价值[J]. 中华养生保健, 2023, 41(4): 22-25.

XU Yan-ling, SHI Xia, DONG Lei, LIU Zhi-juan, LI Nai-han. Application Value of Magnifying Glass OE Pattern Combined with Lugol's Staining Pattern in the Diagnosis of Early Esophageal Cancer and Precancerous Lesions[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(4): 22-25.

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