窄带成像放大内镜联合碘染色“序贯标记法”在食管早期癌及癌前病变内镜黏膜下剥离术中的应用价值

The value of sequential marking in endoscopic submucosal dissection of early esophageal carcinomas and precancerous lesions

摘要:

目的 探讨NBI放大内镜联合碘染色“序贯标记法”在早期食管癌及癌前病变ESD术中的价值。方法 对2014年1月至2017年1月期间接受ESD治疗的97例早期食管癌及癌前病变患者的临床资料进行回顾性分析。术前于NBI放大内镜下确定病变边界者17例（NBI放大组），经碘染色确定病变边界者47例（碘染组），先于NBI放大内镜下标记，然后序贯进行碘染色进一步确定、调整标记范围者33例（序贯组）。比较三组ESD切除标本的水平切缘阳性率。结果 三组间早期食管癌及癌前病变ESD切除标本的水平切缘阳性率存在明显差异，有统计学意义。其中NBI放大组水平切缘阳性率为17.65%（3/17），碘染组为6.38%（3/47），序贯组为0，三组间有统计学差异（P<0.05）。结论 早期食管癌及癌前病变ESD术前采用NBI放大联合碘染色“序贯标记法”，术后标本的水平切缘阳性率更低。

Abstract:

Objective To explore the value of sequential marking in endoscopic submucosal dissection for early esophageal carcinomas and precancerous lesions.Methods A total of 97 patients underwent ESD for early esophageal carcinomas and precancerous lesions at Dongying People"s Hospital between May 2013 and December 2014 were selected for use in the present study. We used NBI magnifying endoscopy in 17 patients to determine the boundary of lesions (NBI magnifying group), while 47 patients used iodine staining (iodine dyeing group), 33 patients used NBI magnifying endoscopy prior to iodine staining to determine the boundary(sequential group). The rate of positive horizontal resection margins of three groups were canculated. Results The rate of positive horizontal resection margins of NBI magnifying group was 17.65% (3/17), while the iodine staining group was 6.38% (3/47), and sequential group was 0, there was a statistical difference among the three groups (P < 0.05). Conclusion：The positive rate of resection margins of patients using NBI magnifying endoscopy prior to iodine dyeing in endoscopic submucosal dissection is lower, that is, this method is more suitable for determing the boundary of early esophageal carcinomas and precancerous lesions.