上消化道表面光滑型隆起性病变的超声内镜诊断与内镜黏膜切除术、内镜黏膜下剥离术术后病理学比较  

Comparison of endoscopic ultrasound with pathological analysis after endoscopic mucosal resection or endoscopic submucosal dissection in the diagnosis of smooth eminence lesions in upper gastroin- testinal tract

作　　者：张卫国[1] 李胜保[1] 郜元军[1] 王强[1] 童强[1] 

机构地区：[1]湖北医药学院附属十堰市太和医院消化内科,十堰442000

出　　处：《临床内科杂志》2013年第8期523-525,共3页Journal of Clinical Internal Medicine

摘　　要：目的探讨超声内镜（EUS）鉴别诊断上消化道表面光滑型隆起性病变的价值。方法182例患者经胃镜检查发现上消化道表面光滑型隆起性病变，超声内镜检查后行内镜黏膜切除术（EMR）或内镜黏膜下剥离术（ESD），比较超声内镜诊断与术后病理学诊断的符合率。结果超声内镜诊断食管平滑肌瘤37例，病理学检查符合33例，符合率为89．2％；食管息肉6例，病理学检查符合2例，符合率为33．3％；食管脂肪瘤1例，病理学检查符合1例，符合率为100％；胃息肉106例，病理学检查符合77例，符合率为72．6％；胃间质瘤19例，病理学检查符合16例，符合率为84．2％；胃脂肪瘤7例，病理学检查符合5例，符合率为71．4％；十二指肠息肉6例，病理学检查符合4例，符合率为66．7％。结论超声内镜检查鉴别诊断上消化道表面光滑型隆起性病变具有一定临床价值，但应结合病理学检查。Objective To investigate the value of endoscopic ultrasound（EUS） in differential di- agnosis of smooth eminence lesions in upper gastrointestinal tract. Methods One hundred and eighty-two patients with smooth eminence lesions in upper gastrointestinal tract were examined by EUS and the data were compared with those from pathological analysis after endoscopic mueosal resection（EMR） or endo- scopic submucosal dissection（ESD）. Results By EUS,33 of 37 eases were diagnosed with esophageal leiomyoma, the diagnostic accuracy rate （ compared with pathological analysis ） was 89.2% ; 2 of 6 eases were with esophageal polyp, the diagnostic accuracy rate was 33.3% ;1 of 1 ease was with esophageal lipo- ma,the diagnostic accuracy rate was 100% ;77 of 106 cases were gastric polyp, the diagnostic accuracy rate was 72.6% ; 16 of 19 eases were gastric stromal tumor, the diagnostic accuracy rate was 84.2% ;5 of 7 eases were gastric lipoma,the diagnostic accuracy rate was 71.4% ;4 of 6 eases were duodenal polyp, the diagnostic accuracy rate was 66.7%. Conclusions This study demonstrates that EUS is a useful ex- amination in differential diagnosis of smooth eminence lesions in upper gastrointestinal tract. However, it has certain limitation and should be combined with the pathological examination.

关 键 词：超声内镜 鉴别诊断 上消化道 隆起性病变 

分 类 号：R735.37[医药卫生—肿瘤]