Diagnostic Value Of Narrowband Imaging, Lugol’s Staining Combined With Endoscopic Ultrasound In Patients With Early Esophageal Cancer

Objective: Carcinoma of the esophagus is a malignant tumor originated in the esophagus, themost common of which is squamous cell carcinoma and the most typical clinical symptom isprogressive dysphagia.As the early patients of esophageal cancer don’t have obvious clinicalmanifestations, in swallowing the clinical manifestations such as pain, dysphagia may appearwhen most patients have been in the middle-late of the course of the disease and lose thechance of early treatment. the5-year survival rate of the patients in the middle-late is less than10%, and it’s about25%after removal of the tumor surgery, and the5-year survival rate of theearly esophageal cancer after the comprehensive treatment is as high as90%~100%, it’ssignificantly higher than the middle-late patients, so the early detection, early diagnosis andearly treatment of the esophageal cancer is very important. Our hospital is located inXinjiang, which belongs to the high incidence place of esophagus carcinoma, so it isnecessary to do further study for improving the rate of early esophageal cancer and increasingthe5-year survival rate. How to do the early detection and treatment is the problem to besolved. To evaluate the value of narrowband imaging，Lugol’s staining combined withendoscopic ultrasound in the diagnosis of early esophageal cancer (EEC).Method: Retrospective analysis was performed in all patients (two groups of402and455respectively), that ordinary white light gastroscope examination showed esophageal focallesions, in our hospital from2004-04/2008-04and2008-06/2012-6. which were defined asany small local mucosal lesions with abnormal shape or color. Biopsy with pathologicalexamination was performed to test the diagnostic accuracy of narrowband imaging，Lugol’sstaining combined with endoscopic ultrasound for EEC.Result：2004-04/2008-04(ordinary white light endoscopy) Group: total402cases,290cases were male, female112cases, the gender ratio is2.6:1, the average age is60.63±12.69years;2008-06/2012-06(WLE+NBI+staining+EUS) group: total455cases,310cases were male, female145cases, the gender ratio is2.1:1, the average age is62.04±13.27years; through SPSS17.0software statistical analysis, There is no gender differences inthe two groups (χ2=1.633, P=0.201>0.05), no difference in the age groups (t=1.58, P=0.115>0.05). WLE and pathology results were compared: the sensitivity is83.58%,thespecificity is75.52%, the accuracy is76.87%. combine with the NBI, staining endoscopic andEUS compared with pathological examination results: the sensitivity is93.48%, thespecificity is83.20%, the accuracy is85.27%. Both methods compared with pathologyresults, analysis by SPSS17.0software, χ2=9.939, P=0.002, there are significantdifferences between the two groups (P <0.05), it is concluded that: The narrowbandimaging，Lugol’s staining combined with endoscopic ultrasound was significantly higher thanwhite light endoscopy in the accuracy of early esophageal cancer.The positive rate compared to statistical analysis by SPSS17.0software, χ2=9.147, P=0.002, two significantdifferences (P <0.05), it is concluded that: NBI+stained endoscopic+EUS was significantlyhigher than ordinary white light endoscopy in the detection of early esophageal cancer.Conclusion: The narrowband imaging，Lugol’s staining combined with endoscopicultrasound is an effective method for the diagnosis of EEC.