超声内镜在早期贲门癌及癌前病变治疗中应用价值  

Value of endoscopic ultrasonography in the treatment of early cardia cancer and precancerous lesions

作　　者：袁丽[1] 张立玮[1] 尔丽绵[1] 郭硕[1] 陈仙梅[1] 李英赛[1] 王士杰[1] 

机构地区：[1]河北医科大学第四医院内镜科,河北石家庄050011

出　　处：《中国内镜杂志》2013年第4期372-375,共4页China Journal of Endoscopy

基　　金：河北省卫生厅重点跟踪项目资金资助(No.GL200905);国际科技合作项目资金资助(No.2009DFA31150)

摘　　要：目的探讨内镜超声检查术(EUS)在早期贲门癌及癌前病变治疗中的临床应用价值。方法病理证实为高级别上皮内瘤变及黏膜内癌的贲门早期癌及癌前病变145例患者行EUS检查判断病变浸润深度,对符合治疗标准的患者行内镜黏膜切除术(EMR),术后病理结果与EUS结果进行对照分析。结果 EUS对早期贲门癌及癌前病变判断浸润深度与术后病理检查结果对照相符者127例,准确率为87.6%,其中对黏膜层癌前病变及早期癌判断的准确率89.5%,对黏膜下层癌前病变及早期癌判断的准确率76.8%;对固有肌层癌判断的准确率75.0%。结论早期贲门癌及癌前病变患者治疗术前行超声内镜检查术可准确评估病灶内镜下切除的可能性,使内镜下黏膜切除更为安全有效,对指导早期贲门癌及癌前病变内镜下治疗具有重要价值。[Objective] To explore the clinical value of endoscopic ultrasound surgery （endoscopicultrasonography,EUS） in the treatment of early cardia cancer and precancerous lesions.[Methods] 145 patients of pathologically confirmed high-level intraepithelial neoplasia or intramucosal carcinoma of the cardia of early cancer and precancerous lesions received EUS check for determining lesion depth of invasion,the patients met the standards received endoscopic mucosal resection （EMR）,surgerypathological results with EUS results were compared.[Result] EUS early cardia cancer and precancerous lesions being consistent with the depth of invasion and pathologic examination results was 127 cases,the accuracy was 87.6%,of which the judgment of the precancerous lesions and early cancer of the mucous layer accuracy rate of 89.5 percent,the submucosaprecancerous lesions and early cancer of judgment accuracy rate of 76.8%;The accuracy of the judgment of the muscularis propria carcinoma was 75.0%.[Conclusion] The early cardia cancer and precancerous lesions of patients with preoperative endoscopic ultrasonography technique can accurately assess the possibility of endoscopic lesions,make endoscopic mucosal resection more safe and effective guidance for early cardia cancer.Precancerous lesionsendoscopic treatment is of great value.

关 键 词：早期贲门癌 癌前病变 超声内镜 内镜黏膜切除术 

分 类 号：R573.7[医药卫生—消化系统]