微探头内镜超声在十二指肠病变诊断中的应用价值

Endoscope ultrasonography with micro-probe in diagnosis duodenal lesions

目的评价微探头内镜超声诊断十二指肠病变的临床应用价值。方法回顾性总结37例十二指肠病变行微探头内镜超声检查患者的临床资料，以内镜黏膜下切除术标本或手术切除标本病理诊断为最终诊断结果，统计微探头内镜超声及内镜下活检对十二指肠病变的诊断符合率。结果微探头内镜超声对十二指肠病变的总体诊断符合率为78．38％（29／37），其中对十二指肠脂肪瘤和十二指肠腺瘤具有较高的诊断符合率，分别为4／4和10／12，对十二指肠早癌及炎性增生性病变的诊断符合率相对较低，分别为2／4和3／8。内镜下活检对十二指肠病变的总体诊断符合率为40．54％（15／37），其中对十二指肠类癌和十二指肠腺瘤具有较高的诊断符合率，分别为1／1和7／12，对十二指肠问质瘤及脂肪瘤的诊断符合率相对较低，分别为1／10和1／4。结论内镜下活检不能作为诊断十二指肠病变的金标准，而微探头内镜超声对十二指肠病变具有较好的临床应用价值。

Objective To evaluate the diagnosis and application values of endoscopic uhrasonography （EUS） with micro-probe in duodenal lesions. Methods Clinical data of 37 patients with duodenal lesions and underwent EUS with micro-probe were analyzed retrospectively. All lesions were treated with endoscopic mucosal resection or surgical resection to get the pathological diagnosis. The diagnostic accuracy of EUS with microprobe and endoscopic biopsy was analyzed respectively. Results The overall diagnosis accuracy of EUS with micro-probe on duodenal lesions was 78.38% （29/37）, with a higher diagnostic rate in duodenal lipoma 4/4 and duodenal adenomas 10/12 than in early duodenal cancer 2/4 or inflammatory hyperplasia 3/8. The overall diagnostic accuracy of biopsy on duodenal lesions was 40. 54% （ 15/37）, with a higher diagnosis rate on duodenal carcinoid 1/1 and adenoma 7/12 than on duodenal stromal tumor 1/10 and lipema 1/4. Conclusion Pathological evaluation of endoscopic biopsy sample is not a golden standard for the diagnosis of duodenal lesions, while EUS with micro-probe has better diagnostic and application value.