微型探头超声胃镜对上消化道隆起性病变的诊断价值

Value of miniature probe endoscopic ultrasonography in diagnosis of protuberant lesion of upper gastrointestinal tract

目的:探讨微探头超声胃镜对上消化道隆起性病变的诊断价值。方法:对356例常规胃镜诊断为不同上消化道隆起性病变的患者行微探头超声胃镜探查,获得临床诊断,并对部分病例获取组织,通过病理检查确诊,分析相关结果。结果:在356例上消化道隆起性病变中,微探头超声胃镜获得临床诊断328例,胃镜获得临床诊断87例,两种胃镜的临床诊断率分别为92.1%、24.1%,差异有统计学意义(P<0.005)。138例获得明确的病理诊断,微探头超声胃镜对上消化道隆起性病变的诊断符合率为73.9%(102/138),明显高于胃镜的诊断符合率28.3%(39/138),两者间差异有统计学意义(P<0.005)。结论:微型探头超声胃镜能准确区分消化道各层,对判断黏膜下肿瘤的起源、大小、性质有很高的应用价值,明显优于常规胃镜。

Objective： To assess the value of miniature probe endoscopic uhrasonography （mEUS） in diagnosis of protuberant lesion of upper gastrointestinal tract. Methods： A total of 356 patients who were ex- amined by common endoscopy with suspected submucosal tumors （SMTs） were diagnosed by mEUS（ Olympus,12,20 MHz）. Some of these patients were subjected to endoscopic minimally invasive therapy, and identified by pathology,which were further analyzed to get relevant results. Results： Among all 356 cases with mucosal protuberant lesion apart from polyps, there were 328 cases diagnosed by mEUS, while only 87 cases that can be accessed and diagnosed by gastroscopy; and the difference between them was significant （P 〈0. 005）. The diagnostic accuracy of mEUS for upper gastrointestinal protuberant lesion was 73.9% （102/138） ; it was significantly higher than 28.3% （39/138） of gastroscopy （P 〈 0. 005 ）. Conclusion： Each layer of the digestive tract can be clearly distinguished by mEUS; it has a high value of practical application for determining the origin, size and nature of the submucosal tumor, and it is superior to common endoscopy.