内镜超声引导下活检钳穿刺式活检对胃壁增厚病变的诊断价值  

EUS-guided aspiration biopsy for gastric lesions with thickened gastric wall

作　　者：吴伟[1] 胡端敏[1] 

机构地区：[1]苏州大学附属第二医院消化内科,苏州215004

出　　处：《中华消化内镜杂志》2016年第2期85-87,共3页Chinese Journal of Digestive Endoscopy

摘　　要：目的评价内镜超声引导下活检钳穿刺式活检对胃壁增厚病变的诊断价值。方法回顾性分析45例内镜超声发现胃壁增厚性病变患者的常规和内镜超声引导下活检钳穿刺式活检的病理结果和随访情况，以手术病理和随访结果为最终诊断，统计常规活检和内镜超声引导下活检钳穿刺式活检的准确率。结果通过常规活检最终诊断为胃癌6例、胃淋巴瘤3例、不典型增生6例、Menetrier’s病2例、炎性改变28例；而内镜超声引导下活检钳穿刺活检发现最终诊断为胃癌18例、胃淋巴瘤5例、不典型增生4例、Menetrier’s病2例、炎性改变16例。最终病理及随访诊断胃癌21例，淋巴瘤6例，不典型增生2例，Menetrier’s病2例，其它恶性肿瘤4例，炎性病变10例。常规活检的准确率为51．11％（23／45），内镜超声引导下活检钳穿刺式活检准确率为82．22％（37／45）。结论内镜超声引导下活检钳穿刺式活检较常规活检对胃壁增厚性病变能明显提高其准确率。Objective To explore the diagnostic value of EUS-guided aspiration biopsy for wall- thickened gastric lesions. Methods A retrospective study was performed in 45 patients who were diagnosed as having thickened gastric wall by EUS examination.Pathological and follow-up results of routine endoscopy and EUS-guided aspiration biopsy were analyzed, with the surgical results and follow-up outcome as the golden standard. The positive rate of routine endoscopy and EUS-guided aspiration biopsy were compared. Results In routine biopsy, gastric cancer was confirmed in 6, lymphoma in 3, dysplasia in 6, Menetrier＇s disease in 2 and inflammatory changes in 28.EUS-guided aspiration biopsy was conducted in 45 patients, and gastric cancer was confirmed in 18, lymphoma in 5, dysplasia in 4, Menetrier＇s disease in 2 and inflammatory changes in 16.The final pathological and follow-up results confirmed 21 gastric cancer, 6 lymphoma, 2 dys- plasia, 2 Menetrier＇s disease, other tumors in 4 and inflammatory changes in 10. The accuracy rate of routine biopsy and EUS-guided aspiration biopsy was 51.11% （23/45） and 82.22% （37/45）respectively. Conclusion EUS-guided aspiration biopsy can yield a higher positive rate than endoscopic biopsy.

关 键 词：内镜超声 细针穿刺抽吸术 胃壁增厚 

分 类 号：R573[医药卫生—消化系统]