超声内镜在上消化道间叶源性肿瘤诊治中的应用价值  

Application value of endoscopic ultrasonography in the diagnosis and treatment of upper gastrointestinal mesenchymal tumors

作　　者：刘凯[1] 刘德全[2] 李艳[1] 姜艳[1] LIU Kai;LIU Dequan;LI Yan;JIANG Yan(Department of Emergency,Shengjing Hospital Affiliated to China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院急诊科,沈阳市110004 [2]中国医科大学附属盛京医院内镜诊治中心,沈阳市110004

出　　处：《临床超声医学杂志》2021年第9期714-716,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨超声内镜在上消化道间叶源性肿瘤(GIMTs)诊治中的应用价值。方法选取我院经常规内镜活检诊断的GIMTs患者80例,均行超声内镜检查,根据内镜表现选择不同治疗方法,术后行病理学检查,分析超声内镜对GIMTs的诊断效能及手术指导价值。结果超声内镜检查显示,脂肪瘤多分布于胃(66.67%),起源于黏膜肌层(50.00%)或黏膜下层(50.00%),低回声、微钙化、边缘不规则占比依次为66.67%、75.00%、50.00%;平滑肌瘤多分布于食管(83.33%),起源于黏膜肌层(83.33%),低回声、微钙化、边缘不规则占比依次为61.90%、69.05%、59.52%;间质瘤多分布于胃(76.92%),起源于固有肌层(38.46%),低回声、微钙化、边缘不规则占比依次为73.08%、69.23%、61.54%。超声内镜准确诊断脂肪瘤10例,敏感性83.33%、特异性92.65%,准确率91.25%;准确诊断平滑肌瘤37例,敏感性88.10%、特异性81.58%,准确率85.00%;准确诊断间质瘤19例,敏感性73.08%、特异性94.44%,准确率87.50%。经超声内镜诊断的60例GIMTs行胃镜下指导治疗,手术均一次性成功,术后未出现穿孔、出血等并发症。术后2个月复查所有患者创面愈合情况良好,肿瘤未见复发。结论超声内镜对GIMTs诊断效果显著,且对患者胃镜切除术选择具有重要指导价值。Objective To explore the application value of endoscopic ultrasonography in the diagnosis and treatment of upper gastrointestinal mesenchymal tumors(GIMTs).Methods Eighty patients with GIMTs diagnosed by regular endoscopic examination were examined by endoscopic ultrasound,and different treatments were selected according to the endoscopic manifestations.Postoperative pathological examination was conducted to analyze the diagnostic efficacy and surgical guidance value of endoscopic ultrasonography in patients with GIMTs.Results Endoscopic ultrasonography showed that lipomas were mostly distributed in the stomach(66.67%),and originated from the muscularis mucosa(50.00%)or submucosa(50.00%).The proportion of hypoechoic,microcalcification,and irregular edges were 66.67%,75.00%and 50.00%,respectively.Leiomyomas were mostly distributed in the esophagus(83.33%),and originated from the muscularis mucosa(83.33%).The proportion of hypoechoic,microcalcification,and irregular edges were 61.90%,69.05%,59.52%,respectively.Interstitial tumors were mostly distributed in the stomach(76.92%),and originated from the muscularis propria(38.46%).The proportion of hypoechoic,microcalcification,and irregular edges were 73.08%,69.23%,and 61.54%,respectively.Endoscopic ultrasonography accurately diagnosed 10 cases of lipoma,with a sensitivity of 83.33%,a specificity of 92.65%,and an accuracy rate of 91.25%.37 cases of leiomyoma were accurately diagnosed with a sensitivity of 88.10%,a specificity of 81.58%,and an accuracy rate of 85.00%.19 cases of stromal tumors were accurately diagnosed with a sensitivity of 73.08%,a specificity of 94.44%,and an accuracy rate of 87.50%.60 cases of GIMTs were diagnosed by endoscopic ultrasonography and underwent gastroscopic guided treatment,the operations were all successful at one time,and there were no complications such as perforation or bleeding after the operation.The wound healing of all patients was rechecked 2 months after the operation,and there was no tumor recurrence.Conclusion Endoscopic ultr

关 键 词：超声内镜 间叶源性肿瘤 上消化道 胃镜切除术 诊断效能 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735[医药卫生—诊断学]