双气囊小肠镜对小肠间质瘤的诊断价值

Value of double balloon endoscopy in diagnosis of small intestinal stromal tumors

目的:评价双气囊小肠镜(double balloon endoscopy,DBE)对小肠间质瘤(small intestine stromal tumors,SISTs)的诊断价值及安全性.方法:回顾性分析2008-05/2013-12中国人民解放军空军总医院经DBE检查诊断为SISTs的30例患者临床资料.结果:30例行DBE检查诊断为SISTs,其中经手术病理证实为SISTs有27例,DBE术前检出正确率为90.0%(27/30),25.9%(7/27)位于十二指肠,59.3%(16/27)位于空肠,14.8%(4/27)位于回场;腹部B超发现病变为33.3%(6/18);多层螺旋CT发现病变为80%(12/15);X线钡餐造影发现病变为66.7%(4/6).肿瘤组织CD117、CD34阳性率分别为92.6%(25/27)、88.9%(24/27).4例患者检查后出现恶心、咽部不适、腹胀等症状,但均能自行缓解,严重并发症发生率较低.结论:DBE检查术前诊断率高,具有较高的诊断价值且安全性高.

AIM： To assess the diagnostic yield and security of double balloon endoscopy （DBE） in small in- testinal stromal tumors （SISTs）. METHODS： We retrospectively reviewed clini- cal data for 30 patients who had received DBE for SISTs at our hospital from May 2008 to De- cember 2013. RESULTS： Of the 30 patients who underwent DBE for SISTs, 27 were confirmed to have SISTs by surgery and pathology, and the preopera- tive diagnostic accuracy rate of DBE was 90.0% （27/30）. Of the 27 confirmed cases, 25.9% （7/27） were found in the duodenum, 59.3% （16/27） in the jejunum, and 14.8% （4/27） in the ileum. Abdominal ultrasound showed 33.3% （6/18） of lesions, MDCT showed 80.0% （12/15）, and X-ray barium meal showed 66.7% （4/6）. The positive rates of CDl17 and CD34 in tumors were 92.6% （25/27） and 88.9% （24/27）, respectively. Nausea,throat discomfort, bloating and other symptoms were present in some patients after DBE, all of which resolved spontaneously. The rate of se- vere complications was low. CONCLUSION： DBE has a high preoperative diagnosis rate for SISTs, showing high diagnosis value and high safety.