胃肠道神经内分泌肿瘤的内镜误诊体会  

Experience of endoscopic diagnosis and treatment for gastrointestinal neuroendocriue tumor

作　　者：邓万银[1] 梁玮[1] 何利平[1] 郑金辉[1] 郑晓玲[1] 杨士杰[1] 

机构地区：[1]福建医科大学省立临床医学院消化内镜中心,福建福州350001

出　　处：《中国内镜杂志》2016年第12期85-89,共5页China Journal of Endoscopy

基　　金：福建省卫生系统中青年骨干人才培养项目(No:2015-ZQN-ZD-5)

摘　　要：目的探讨胃肠神经内分泌肿瘤(GI-NETs)内镜诊治特点,减少误诊。方法收集2012年1月-2014年11月该院内镜诊断的84例神经内分泌肿瘤(NET),回顾性分析其白光内镜、超声内镜(EUS)、组织病理学及治疗后情况等特点,总结其中误诊病例特点。结果经内镜诊断NET 84例,最终经病理证实为NET 72例,12例内镜误诊为NET,误诊率达14.3%,12例分别为慢性炎症5例,异位胰腺2例,布氏腺增生1例,大肠增生性息肉1例,大肠静脉型血管瘤1例,大肠平滑肌瘤1例,转移性鳞癌1例。8例行EUS检查,均提示病灶来源黏膜下层,6例为低回声,1例偏高回声(布氏腺增生),1例混合回声(静脉型血管瘤)。结论 GI-NETs在内镜下有一定的特征性,但有部分病例表现可类似,经过更为细致的观察和必要的活检可增加诊断的准确率。Objective To study the characteristics of endoscopic diagnosis and treatment for gastrointestinal neuroendocriue tumor （GI-NETs）.Methods We retrospectively collected the clinical data of 84 patients with endoscopic confirmed GI-NETs from January 2012 to November 2014, including white light, endoscopic ultrasonography, histopathology and post-treatment condition.Results Endoscopic diagnosis for NET were 84 cases, but ifnally conifrmed by pathology were 72 cases, the misdiagnosis rate was 14.3%. Of the 12 misdiagnosed cases, 5 cases were chronic inlfammation, ectopic pancreas in 2 cases, and 5 cases of hyperplasia of Brunner＆#39;s glands, colorectal hyperplastic polyps, colorectal venous hemangioma, colorectal leiomyoma, metastatic squamous carcinoma respectively. Of 8 cases with EUS, all lesions derived from the submucosal layer, and 6 cases of low echo, and 2 cases of high echo （Brunner＆#39;s glands） and mixed echo （venous hemangioma） respectively.Conclusions GI-NETs,which possess certain characteristics under endoscopy, may be similar with other digestive diseases, while it can increase the diagnosis accuracy by more careful observation and necessary biopsy.

关 键 词：胃肠神经内分泌肿瘤 超声内镜 内镜治疗 误诊 

分 类 号：R735.3[医药卫生—肿瘤]