- 期刊
Lugol染色內視鏡術(chromoendoscopy)在食道癌的應用
Application of Lugol Chromoendoscopy on the Diagnosis of Early Esophageal Cancer
摘要
傳統消化道內視鏡只能發現有突出腫塊、潰瘍或明顯黏膜顏色改變的進行性食道癌病徵，對於無上述變化與症狀的早期食道鱗狀細胞癌(squamous cell carcinoma, SCC)則不容易以傳統內視鏡的檢查方法診斷。自30年前Lugol's solution閉始被應用於診斷食道鱗狀細胞癌，現今已有眾多報告證明此一方便廉價之染色法在輔助開刀切除、應用於內視鏡篩檢高危險群病患，及偵測早期食道癌以利內視鏡切除術皆扮演重要之角色。尤其在昂貴的高科技醫療影像設備(EUS, PET, EOCT)與分子生物學癌症基因研究正熱門之際，應用如Lugol chromoendoscopy(LCE)技術的染色觀察，以簡單之組織化學反應染色法便可以早期診斷食道癌症，值得內視鏡操作者多加學習與應用，以利日漸成熟之內視鏡超音波(endoscopic ultrasound, EUS)及內視鏡黏膜切除術(endoscopic mucosal resection, EMR)等的運用。
並列摘要
Conventional esophago gastro duodenoscopy can disclose a lesion only when it presents as a protuberant mass, an ulceration or when there is significant discoloration. When an early esophageal squamous cell carcinoma or dysplasia, frequently lacking such changes, is confronted, conventional endoscopy usually fails to detect it. Combination of endoscopy and mucosal staining, known as chromoendoscopy, deserves to be praised in the detection of early lesions aforementioned. Since the initial report of Lugol's solution on the diagnosis of esophageal cancer 30 years ago, more and more publications have agreed with its usefulness as an assistant tool in the diagnosis of early esophageal cancer. Examples of its benefits include improving surgical decision making, better screening of high risk patients and facilitating endoscopic mucosal resection. With the growing popularity of much more expensive modalities such as EUS, PET, EOCT and molecular genetic technology; this convenient and non-expensive technique is worth practicing by endoscopist.