内镜超声对消化道早期肿瘤黏膜下微浸润判断的准确性  

Accuracy of endoscopic ultrasonography for evaluating minimal submucosal invasion of early gastrointestinal tumor

作　　者：赵芯[1] 任贵[1] 吕文浩[1] 刘敏[1] 刘志国[1] 郭学刚[1] 吴开春[1] 

机构地区：[1]第四军医大学西京消化病医院,西安710005

出　　处：《中华消化内镜杂志》2016年第2期80-84,共5页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨内镜超声对消化道早期肿瘤黏膜下微浸润的判断价值。方法对242例内镜黏膜下剥离术后病理确诊的消化道早期肿瘤病例进行回顾性分析，以病理结果为金标准统计术前内镜超声判断消化道早期肿瘤黏膜下微浸润的准确率，并分析其影响因素。结果内镜超声对消化道早期肿瘤黏膜下微浸润的总体判断准确率为72．3％（175／242），过判率和漏判率分别为21．5％（52／242）、6．2％（15／242）。肿瘤大小（P=0．018）和部位（P=0．005）对内镜超声判断消化道早期肿瘤黏膜下微浸润的准确性有明显影响，病变长径〉3cm的过判率高于病变长径≤3cm者[27．0％（33／122）比15．8％（19／120），P=0．807]，肠道和胃早期肿瘤的过判率均明显高于漏判率[肠道：12．2％（9／74）比2．7％（2／74），P=0．028；胃：26．9％（28／104）比2．9％（3／104），P=0．000]。结论内镜超声对判断消化道早期肿瘤黏膜下微浸润具有一定意义，但应警惕较大病灶及胃肠道病灶易发生过判情况。Objective To explore the diagnostic value of endoscopic ultrasonography （EUS） for the minimal submucosal invasion of early gastrointestinal tumor. Methods A total of 242 patients with early gastrointestinal tumor, who underwent endoscopic submucosal dissection, were retrospectively analyzed. The accuracy of EUS diagnosis was calculated based on postoperative histopathological findings as the golden standard, and influencing factors were also analyzed. Results Overall diagnostic accuracy of EUS for sub- mueosal invasion of early gastrointestinal tumors was 72. 3% （ 175/242）, with an overstaging rate of 21.5% （52/242） and an understaging rate of 6. 2% （15/242） .Tumor size （ P = 0. 018 ） and location （ P = 0. 005 ） had significant effects on the diagnostic accuracy of the minimal submucosal invasion of early gastr6intestinal tumor by EUS. The overstaging rate in the lesion length of diameter〉3 cm was higher than those of 3 em or less[ 27.0% （33/122） VS 15.8% （ 19/120）, P = 0. 807 ], the overstaging rates of early colonrectal and gastric cancer were also significantly higher than the understaging rate [ Colonrectum： 12. 2% （9/74） VS 2.7% （2/74）, P=0.028; Stomach： 26.9% （28/104） VS 2.9% （3/104）, P=0.000]. Conclusion Endoscopic ultrasonography is of diagnostic value for the invasion depth of early cancer in gastrointestinal tract. However, precaution should be taken in large lesions and the tendency of overstaging in gastrointestinal tract.

关 键 词：内镜超声 黏膜下微浸润 消化道早期肿瘤 

分 类 号：R735[医药卫生—肿瘤]