内镜超声诊断胃肠道黏膜及黏膜下隆起性病变432例  

Diagnosis of gastrointestinal mucosal and submucosal protuberant lesions by endoscopic ultrasonography: an analysis of 432 cases

作　　者：于衍会[1] 高善玲[1] 

机构地区：[1]哈尔滨医科大学第二附属医院消化内科,黑龙江省哈尔滨市150086

出　　处：《世界华人消化杂志》2011年第16期1745-1748,共4页World Chinese Journal of Digestology

摘　　要：目的:探讨内镜超声(EUS)对胃肠道黏膜及黏膜下隆起性病变诊断的价值,分析胃肠道黏膜及黏膜下隆起性病变与术后临床病理诊断符合率.方法:回顾性分析胃肠道黏膜及黏膜下隆起性病变的临床资料.3100例患者术前行EUS检查,其中432例进行内镜下活检、息肉摘除术、EMR或ESD等治疗,术后将切除标本送病理.再将病理结果与术前内镜超声结果相比较,分析二者的相关性及符合率.结果:432例胃肠道黏膜及黏膜下隆起性病变中,黏膜层活检、摘除术后病理诊断与EUS诊断符合率为88.18%(306/347);黏膜下层病变EMR或ESD术后病理诊断与EUS诊断符合率为55.29%(47/85);EUS与内镜下活检、摘除、ESD或EMR术后病理结果总符合率81.71%(353/432).不符合病例中以少见病例以及EUS图谱未列出的病变为主.结论:EUS对胃肠道黏膜及黏膜下隆起性病变可以判断其病变起源、回声特征以及肿物的大小及边缘情况,但能否准确辨别全部病变的性质还有待提高.对EUS检查到的可疑胃肠道黏膜及黏膜下隆起性病变,在内镜下进行活检、摘除、ESD或EMR术,进行病理检查是必要的.AIM： To study the clinical value of endoscopic ultrasonography （EUS） in the diagnosis of mucosal and submucosal protuberant lesions of the digestive tract. METHODS： A total of 3 100 patients with mucosal and submucosal protuberant lesions of the digestive tract who underwent EUS before operation were retrospectively analyzed, and 432 patients who also underwent postoperative pathological examination after endoscopic biopsy, endoscopic resection, EUS or ESD were included in this study. The results of preoperative examination were compared with those of postoperative pathological diagnosis. RESULTS： The diagnostic coincidence rate between pathological examination and EUS was 88.18% （306/347） for mucosal protuberant lesions, 55.29% （47/85） for submucosal protuberant lesions, and 81.71% （353/432） for allprotuberant lesions. Rare diseases and diseases not listed in the endoscopic ultrasound map accounted for a major share of the non-coincidence cases. CONCLUSION： EUS can help judge the origin, characteristics of echo, as well as tumor size, margin for protuberant lesions of the digestive tract, but can not accurately identify the nature of the disease. Pathological examination following endoscopic biopsy, surgery, ESD or EMR is necessary in patients with a doubtful diagnosis.

关 键 词：内镜超声检查术 胃肠道 隆起性病变 病理 

分 类 号：R57[医药卫生—消化系统]