贲门胃底部固有肌层起源肿物的超声内镜诊断与分型研究  

Endoscopic ultrasonography diagnosis and classification of gastric fundus-cardiac tumors originated from the muscularis propria

作　　者：韩笑[1] 赵志峰[1] 匡丽[2] 

机构地区：[1]沈阳军区总医院内窥镜科,沈阳110016 [2]沈阳军区总医院病理科,沈阳110016

出　　处：《解放军医学杂志》2016年第8期660-663,共4页Medical Journal of Chinese People's Liberation Army

基　　金：辽宁省科技攻关计划(2012225019)~~

摘　　要：目的探讨贲门胃底部固有肌层起源肿物超声内镜诊断与分型的方法。方法沈阳军区总医院内窥镜科2011年1月-2015年6月间经超声内镜诊断为贲门胃底部固有肌层起源肿物的患者102例,均经内镜或外科治疗获得确切病理结果,其中行内镜下微创剥离切除83例,外科手术切除19例。对所有病例的超声内镜及术后完整病理诊断资料进行回顾性分析。结果 102例患者中男39例,女63例,年龄56.2±12.0（25-85）岁。病变大小3.72±2.18（0.4-10.4）cm。术前超声内镜诊断平滑肌瘤81例,间质瘤21例。术后病理及免疫组化证实5例平滑肌瘤术前误诊为间质瘤,误诊率为4.9%（5/102）。平滑肌瘤患者中孤立结节型29例,蚓型21例,多结节型36例。结论超声内镜是贲门胃底部固有肌层起源肿物安全有效的诊断和分型方法。Objective To investigate endoscopic ultrasonography diagnosis and classification of gastric fundus-cardiac tumors originated from the muscularis propria. Methods One hundred and two patients with gastric fundus-cardiac submucosal tumors originated from the muscularis propria were diagnosed by endoscopic ultrasonography from Jan, 2011 to Jun, 2015. All patients were treated by endoscopy or surgery, and diagnosed by postoperative pathology and immunohistochemistry staining. These cases were analyzed retrospectively. Results The 102 patients with gastric fundus-cardiac tumors originated from the muscularis propria included 39 men and 63 women. Their ages were from 25-85 years old, average 56.22±11.98 years. The tumor sizes were from 0.4 to 10.4cm, average 3.72±2.18 cm. The patients were diagnosed having leiomyoma in 81 and interstitialoma in 21 by preoperative endoscopic ultrasonography. Postoperative pathology and immunohistochemistry staining confirmed that leiomyoma was misdiagnosed as mesenchymoma in 5 patients. The misdiagnosis rate of endoscopic ultrasonography for gastric fundus-cardiac tumors originated from the muscularis propria was 4.9%（5/102）. In leiomyomas, isolated nodular type was seen in 29 cases, earthworm type in 21, and multiple nodular type in 36. Conclusion Endoscopic ultrasonography is a safe effective important method for diagnosis and classification of gastric fundus-cardiac submucosal tumors originated from the muscularis propria.

关 键 词：贲门胃底部 固有肌层起源肿物 超声内镜 

分 类 号：R735.2[医药卫生—肿瘤]