超声内镜对胃肠道间质瘤诊断价值的分析

Values of Endoscopic Ultrasonography in Diagnosis of Gastrointestinal Stromal Tumor

目的探讨超声内镜(EUS)较常规内镜对胃肠道间质瘤(GISTs)临床诊断的优越性。方法对照手术病理及免疫组化结果,比较常规内镜和EUS对我院收治的40例GISTs患者术前诊断情况。结果常规内镜下GISTs主要表现为隆起型病变,表面可见溃疡、出血及糜烂,术前诊断准确率为22.5%(9/40)。EUS下GISTs主要表现为低回声光团,内部回声多不均匀,可以清晰观察到肿瘤的起源层,术前诊断准确率为85.0%(34/40),显著高于常规内镜术前诊断准确率(P<0.01)。EUS检查发现GISTs的直径≤4 cm者良性率显著高于>4 cm者(P<0.05);回声均匀者良性率显著高于不均匀者,差异有统计学意义(P<0.05)。结论常规内镜不如EUS对GISTs的术前诊断准确率高;EUS可以通过测量肿瘤直径及辨别回声特点,在一定程度上预测肿瘤的良恶性。

Objective To explore the advantage of endoscopic ultrasonography（EUS） over routine endoscopy in diagnosis of gastrointestinal stromal tumors（GISTs）.Methods According to surgical pathology and immunohistochemical results of 40 cases with GISTs,preoperative diagnosis between conventional endoscopy and endoscopic ultrasonography were contrasted.Results The protruded type lesions were main performance of GISTs under conventional endoscopy,ulcer hemorrhage or corrupted were obviously seen on its surface.The total accurate rate of preoperative diagnosis from conventional endoscopy towards GISTs were approximately 22.5%（9/40）;While the main performance of GISTs under endoscopic ultrasonography were low and uneven echogenic mass,besides,the original of tumor could be clearly observed.The total accurate rate of preoperative diagnosis from endoscopic ultrasonography towards GISTs were approximately 85.0%（34/40）,that was significant higher than the total accurate rate of conventional endoscopy（P0.01）.When the diameter of GISTs were not larger than 4 centimeter or the echo were even under the endoscopic ultrasonography,the benign character of GISTs could be forecasted（P0.05）.Conclusion Comparing with EUS,preoperative diagnosis of GISTs are not easily tested by conventional endoscopy.Preoperative diagnosis of GISTs with EUS has a great superiority,because the tumor diameter size can be accurately measured and echo properties can be distinguished,which can predict the benign or malignant character of tumor at a certain extent.