超声内镜引导深挖活检联合黏膜切除术诊治早期直肠类癌  

EUS-guided deep biopsy and endoscopic mucosal resection( EMR) in the early diagnosis and treatment of rectal carcinoid tumors

作　　者：赵舒畅[1] 庄文侠[2] 高菲 傅春彬[1] 

机构地区：[1]吉化总医院消化内科 [2]吉化总医院炼油厂职工医院 [3]吉林石化矿区服务事业部医疗卫生管理处,吉林省吉林市132021

出　　处：《临床消化病杂志》2013年第5期302-304,共3页Chinese Journal of Clinical Gastroenterology

摘　　要：目的探讨超声内镜引导下深挖活检早期诊断直肠类癌以及内镜下黏膜切除术治疗直肠类癌的安全性、有效性。方法在超声内镜引导下深挖活检、结合病理及免疫组化检查,诊断直肠类癌24例。对24例直肠类癌的内镜及超声影像特点进行回顾性分析,总结其特征。对病灶直径小于1.5 cm、浸润深度不超过黏膜下层、无肝转移及腹水发生的直肠类癌采取内镜下黏膜切除术治疗。结果 24例直肠类癌分别距离肛缘5 cm^12 cm,病灶大小0.8cm^1.5 cm,术后切除的标本切缘完整,基底无残留,治疗过程中均未发生穿孔,无迟发性出血,术后创面即刻渗血1例,经内镜治疗血止。随访3至5年无转移及再发。结论直肠类癌可通过超声内镜引导下深挖活检,钳取组织行病理及免疫组化检查而确诊,内镜下黏膜切除术治疗直径小于1.5 cm的直肠类癌简单、安全有效。Objective To evaluate the effect of EUS-guided deep biopsy on diagnosis of early rectal carcinoid tumors and its safety. Methods Diagnosed 24 patients with rectal carcinoid tumors though EUS-guided deep biopsy（ combined biopsy with immunohistochemistry） were invdred. The clinical data of the 24 patients with rectal carcinoid tumors were analyzed retrospectively. The tumors whose depth of infiltration was limited within submucosa, 〈 1.5 cm in diameter and no ascites were treated by endoscopic mucosal resection. Results The tumors （ lesion size 0. 8 cm to 1.5 cm in diameter） in 24 patients were located within 5 cm to 12 cm of the anal verge. No tumor residues at the border or base of the resected specimens. Of the 24 patients receiving endoscopic therapy, one developed immediate bleeding, no one developed delayed bleeding and perforation. The patient developed immediate bleeding recovered after receiving endoscopic therapy. During the followup visit within three to five years, no patient had metastases and recurrence. Conclusion Rectal carcinoid tumors can be diagnosed by EUS guided deep biopsy and immunohistochemistry examination. Endoscopic mucosal resection（EMR） treatment is a simple and safe procedure for the treatment of rectal carcinoid tumors 〈 1.5 cm in diameter.

关 键 词：超声内镜 直肠类癌 深挖活检 内镜下粘膜切除术 

分 类 号：R735.3[医药卫生—肿瘤]