摘要目的 探讨内镜下lugol液染色联合p53蛋白检测对早期食管癌的诊断价值.方法 将胃镜下有可疑食管病变的120例患者随机分为染色组和对照组各60例.用复方碘溶液对染色组进行食管黏膜染色检查,并于不染色或淡染色区进行病理活检,并行p53蛋白检测.对照组不行碘染色,仅根据临床经验进行病理活检.结果 观察组染色组不染色或淡染色38例,活检发现早期食管癌12例(20.00%),中重度异型增生11例(18.33%);对照组发现早期食管癌5例(8.33%),中重度异型增生6例(10.00%).两组食管癌诊断率的差异有统计学意义.p53蛋白阳性率重度不典型增生～鳞癌组和正常鳞状上皮～轻度不典型增生组分别为30.51%、10.71%,其中中重度不典型增生～鳞癌组p53蛋白表达阳性率明显高于正常鳞状上皮～轻度不典型增生组(P＜0.05).结论 通过染色内镜对高危易感人群进行筛检,对上述检查结果阳性患者行内镜下取活组织病理检查,同时进行p53蛋白分析,可以提高早期食管癌的诊断率.

abstractsObjective To investigate the significance of Lugol' siodine staining combining with examination of p53 protein in early esophageal cancer. Methods Esophageal mucasa of 120 cases of highly dangerous people of esophageal carcinoma were divided into staining group control groug randornly each with 60 cases and dyed by Lugol's solution orthopticly in endoscopy, The lesions founded was biopsied with pathologic method and the expression of p53 protein was examined by immunohistochemistry. Biopsy was performed depending on the doctor's clinical experience in the control,which was not performed staining. Results There were 38 cases unstained or light-stained in the staining group including 11 cases of moderate-severe hyperplsia, 12 places of early squamous cellcarcinoma. Patholo-gical examinations in the control group discovered that 5 cases (8.33%)of esophageal cancer and 6 cases( 10.00% )of middle-severe dysplasia. Significant difference of the diagnostic rates of esophageal cancer was observed between the two groups. The positive rate of p53 were 30.51% and 10.71% in moderate-severe hyperplsia ～ squamous cell carcinoma compared with squamous cell ～ low grade hyperplsia group respectively. There was statistical significant between them ( P ＜ 0.05 ). Conclusion Screening of high dangerous people with chromoendoscopy following biospy, pathologicdetection and p53 protein examination can increase diagnostic rate of early esophagealcarcinoma.