上消化道平滑肌肿瘤内镜诊治  

Smooth muscle tumors of upper gastrointestinal tract :a diagnostic and therapeutic analysis of endoscopy

作　　者：李建英[1] 于皆平[1] 罗和生[1] 邹丽萍[1] 杨咏梅[1] 

机构地区：[1]武汉大学人民医院消化内科,430060

出　　处：《中华消化内镜杂志》2002年第2期95-97,共3页Chinese Journal of Digestive Endoscopy

摘　　要：目的总结上消化道平滑肌肿瘤发病情况及其内镜特点，探讨其良、恶性病变的诊治方法。方法对２５年间经手术和病理证实的１５６例上消化道平滑肌肿瘤进行回顾性分析。结果１５６例上消化道平滑肌肿瘤中平滑肌瘤１２６例，平滑肌肉瘤３０例，内镜确诊率８１．４％。食管平滑肌瘤较多见，且多为≤２　ｃｍ的小平滑肌瘤（７８．２％）；７３．３％的平滑肌肉瘤表面有溃疡形成，而平滑肌瘤表面溃疡仅为１４．３％，两者差异显著（Ｐ＜０．０１）；肿瘤长径≤２　ｃｍ者７５．４％为平滑肌瘤，＞　５　ｃｍ者７６．７％为平滑肌肉瘤。９５例直径≤　２　ｃｍ的平滑肌瘤经内镜推顶圈套法切除，无严重并发症发生。结论食管小平滑肌瘤较多见；肿瘤大小及表面溃疡为内镜下鉴别平滑肌瘤与肉瘤的重要依据；内镜下推顶圈套法切除直径≤　２　ｃｍ的平滑肌瘤安全、有效。Objective To investigate the clinical and endoscopic features of smooth muscle tumors in upper gastrointestinal tract and evaluate the diagnostic and therapeutic methods of leiomyoma and leiomyosarcoma.MethodsThe documents of 156 cases with smooth muscle tumors in upper gastrointestinal tract proved by surgery and histopathology in past 25 years were retrospectively reviewed and analysed.Results156 cases of smooth muscle tumors in upper gastrointe stinal tract included leiomyoma 126 cases and leiomyosarcoma 30 cases. Leiomyoma were found mainly in esophagus, Most of them (78.2%) were small ones with diameter≤2 cm. The incidence of tumors with ulceration were found higher in leiomyosarcoma (73.3%) than in leiomyoma(14.3%)(P<0.01). 75.4% leiomyoma appeared ≤2 cm in diameter, 76.7% of leiomyosarcoma exceeded 5 cm in diameter. 95 cases of leiomyoma with diameter ≤2 cm were resected by push snare cauterization.Conclusion Leiomyomas in upper gastrointestinal tract were found mainly in esophagus. The size and ulceration of tumors can be considered as an important evidence of distinguishing leiomyoma from leiomyosarcoma .The satisfactory results suggested that the method of push snare cauterization was safe and effective in dealing with leiomyoma ≤2 cm in diameter.

关 键 词：上消化道平滑肌肿瘤 内镜检 治疗 

分 类 号：R735[医药卫生—肿瘤]