食管低回声病灶内镜诊治分析

Endoscopic diagnosis and treatment of esophageal hypoechoic lesions

目的了解食管低回声病灶的内镜下特点及病理表现。方法对超声微探头检查发现的650例食管低回声病灶的部位、距门齿的距离、病变层次及病理情况进行分析,男女分组,观察两性别间的差异。结果食管低回声病灶男性比女性多见,男∶女为1.69∶1,男性以胸中下段多见,而女性以胸中上段为多。病灶主要位于黏膜层399例,肌层235例,女性患者病变在黏膜层的比例要高于男性组。137例病灶行内镜下切除,130例为平滑肌肌瘤,其中15例行免疫组化检查,1例明确为间质瘤。结论食管黏膜层的低回声病变,以平滑肌肌瘤常见,间质瘤少见,病灶部位于胸中段最为常见,在病变的位置,起源上男女之间存在一定差异。

Objective To study the endoscopic characteristics and pathologic features of esophageal hypoechoic lesions.Methods Six hundred and fifty cases of esophageal hypoechoic lesions were analyzed retrospectively by endoscopic miniprobe ultrasonography for their locations,distance to the incisor,involved layer and pathology.Gender difference of the lesions was explored.Results Esophageal hypoechoic lesions were more common in males than in females（m∶f = 1.69∶1）.It was more common in the lower and middle thoracic segment in males,and more common in the middle and upper thoracic segments in females.Three hundred and ninety-nine cases lesions were in the mucosa,and 235 cases lesions were in the muscularis propria.Mucosal lesions were more common in females.One hundred and thirty-seven cases lesions were resected under endoscopy,of which 130 cases were leiomyoma.Iimmunohistopathology was available in 15 cases for the latter part,1 case of definite GIST was revealed.Conclusion Leiomyomas are the most common at esophageal mucosa hypoechoic lesions,while GIST is rare.The lesions are more common in the middle segment.Location and involved layer of the lesions differ in some extent between the males and females.