超声小探头在大肠侧向发育型肿瘤术前评估的价值  

Application of ultrasonic miniprobe in preoperative assessment of laterally spreading tumor in the colon and rectum

作　　者：朱大磊 何玉善 肖宝星 颜冬梅 

机构地区：[1]湖南邵阳市中心医院消化科,422000

出　　处：《现代消化及介入诊疗》2015年第6期592-595,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

摘　　要：目的探讨超声小探头在大肠侧向发育型肿瘤（LST）术前评估的临床价值。方法对肠镜检查发现大于1 cm的50例LST,超声内镜评估后,行EMR或ESD或外科手术治疗,分析病变的超声特征及术后标本组织病理学变化。结果 50例大肠LST,肿瘤直径1.2~3.0 cm,平均2.0 cm。EUS下40例LST黏膜层高回声改变,内部回声均匀,黏膜下完整,8例黏膜层部分低回声改变,1例黏膜下高回声变窄,1例黏膜下出现断裂。术后组织病理学检查36例为管状腺瘤低级别瘤变,6例绒毛状腺瘤高级别瘤变,5例管状绒毛状腺瘤高级别瘤变,2例黏膜下癌（追加外科手术）,1例高分化腺癌侵及浅肌层。结论LST术前超声小探头的回声特点,有助于判定病变性质和选择治疗方案。Objective To evaluate the application of ultrasound miniprobe in preoperative assessment of laterally spreading tumors （LSTs） in the colon and rectum. Methods After the endoscopic ultrasonography （EUS） assessment, 50 LSTs with the diameter larger than lcm were removed by EMR or ESD or surgery. Characteristics of EUS and postoperative pathology of the removed lesions were retrospectively evaluated. Results The diameter of lesions ranged from 1.2 cm to 3.0 cm, average 2.0 cm. Ultrasonically,40 cases had high-level echo in mucosa and 8 cases had low echo-level in mucosa with a complete submucosa. One case had a narrow high level echo in submucosa, and 1 case had a breakage in submucosa. Pathological diagnosis revealed low-grade intraepithelial dysplasia in 36 cases, high-grade intraepithelial dysplasia in 11 cases, submucosal carcinomas in 2 cases. Conclusion The application of utrasonic mini-probe in preoperative assess- ment of LST is helpful to detect lesion malignant transformation and choose therapy.

关 键 词：超声小探头 大肠侧向发育型肿瘤 内镜黏膜下剥离术 

分 类 号：R735.34[医药卫生—肿瘤]