超声内镜术前诊断及内镜黏膜下剥离术治疗直肠类癌的研究  

The Study of Preoperative Diagnosis by Endoscopic Ultrasonography and Treatment with Endoscopic Submucosal Dissection in Patients with Rectal Carcinoid Tumors

作　　者：郜元军[1] 李胜保[1] 雷玉娥[1] 郭艳[1] 姜东升[1] 屠新华[1] 张卫国[1] 

机构地区：[1]湖北医药学院附属太和医院消化内科,湖北十堰442000

出　　处：《湖北医药学院学报》2014年第6期576-578,F0003,共4页Journal of Hubei University of Medicine

摘　　要：目的：研究超声内镜在直肠类癌术前诊断的价值及内镜黏膜下剥离术（ESD）在直肠类癌治疗中的应用效果。方法：对8例用ESD方法治疗的直肠类癌经行临床、病理分析及随访观察。结果：我院自2012年5月至2013年6月诊断8例直肠类癌,直径大小约0.5-1.2 cm,超声内镜（EUS）表现为起源于黏膜下层或黏膜深层的低回声病变,固有肌层无累及。8例患者全腹部及胸部CT检查无转移,均行ESD完整剥离,术后病理及免疫组织化学检查证实类癌,切缘及基底阴性。术后随访16-27月,未见局部复发及全身转移。结论：ESD是治疗无固有肌层浸润及转移的直肠类癌的有效方法,EUS有助于该疾病的术前诊断及浸润深度判断,术前活检并非必要。Objective To assess the value of endoscopic ultrasonography（EUS） for preoperative diagnosis and the therapeutic effects of endoscopic submueosal dissection（ESD） in patients with foetal careinoid tumors. Methods The clinical and pathologieal data of 8 patients with rectal eareinoid tumor treated by ESD were analyzed and followed. Results From May 2012 to June 2013,8 patients confirmed with rectal carcinoid tumor received EUS in our hospital. The diameter of tumors was from 0.5 to 1.2 cm. EUS showed submucosal or deep mucosal with hypoechoie mass, but muscularis propria not involved. No metastasis was found by CT scan. All cases underwent ESD after the examination, and confirmed by pathology and immunohistology, meanwhile the cutting edge and basement showed negative. Intraoperative perforation and postoperative hemorrhage were not found in all cases. Following-up for 16 to 30 months,none of them had recurrence or metastasis. Conclusion ESD is a safe and effective method to treat rectal earoinoid tumor without museularis propria involvement and metastasis. EUS can be used for preoperative diagnosis in rectal carcinoid tumor, and preoperative biopsies is not necessary.

关 键 词：直肠类癌 超声内镜 内镜黏膜下剥离术 

分 类 号：R735.37[医药卫生—肿瘤]