ESD对分泌性肿瘤和上皮性肿瘤治疗的临床评价

Clinical value of ESD in the neuroendocrine neoplasm and epithelial neoplasia

[目的]探索ESD手术对分泌性肿瘤和上皮性肿瘤的临床治疗效果。[方法]选取我院2014年5月~2016年9月做ESD手术的分泌性肿瘤和上皮性肿瘤患者102例,对比2组病变的发生部位、病变形态、大小和出血量。[结果]分泌性肿瘤的发生部位多分布在直肠(61.9%),上皮性肿瘤的发生部位多分布在胃(60.0%),2组病变发生部位有统计学差异(P<0.01)。2组病变的形态隆起型(Is,Isp)占比为14.2%16.7%,平坦型(Ⅱa,Ⅱb,LST)占比为66.7%48.3%,凹陷型(Ⅱc,Ⅱa+Ⅱc,Ⅱb+Ⅱc)占比19.1%35%,差异无统计学意义(P=0.309);分泌性肿瘤术中出血量大于上皮性肿瘤(37.2±13.2ml26.5±8.1ml,P<0.01),病变直径分泌性肿瘤小于上皮性肿瘤(6.2±3.2mm16.9±8.8mm,P<0.01),均具有统计学意义。[结论]ESD手术对分泌性肿瘤的治疗比上皮性肿瘤操作难度大,更需严格把控适应症。

[Objective]To explore the clinical therapeutic effect of ESD operation on neuroendocrine neoplasm and epithelial neoplasia.[Methods]In our hospital,from May 2014 to September 2016,102 cases of neuroendocrine neoplasm and epithelial neoplasia received ESD surgery.And the location,the shape,size and amount of bleeding of the lesions of the 2groups were observed.[Results]The neuroendocrine neoplasm was located in the rectum（61.9%）,and the epithelial neoplasia was located in the stomach（60%）,and there were significant differences between the 2groups（P〈0.01）.Lesions in the 2groups：Bulge type（Is,Isp）accounted for 14.2% vs 16.7%,flat type（ⅡaⅡb,LST）accounted for 66.7% vs 48.3%,depressed type（ⅡcⅡa＋ ⅡC Ⅱb＋ ⅡC）accounted for 19.1% vs 35%,and there was no statistical significance（statistics P=0.309）;in the neuroendocrine neoplasm amount of bleeding was more than that in epithelial neoplasia during the operation（37.2±13.2ml vs 26.5±8.1ml,P〈0.01）,and lesion diameter of neuroendocrine neoplasm was less than that in epithelial neoplasia（6.2±3.2mm vs 16.9±8.8mm,P〈0.01）.[Conclusion]ESD surgery is more difficult for the treatment of neuroendocrine neoplasm than epithelial neoplasia,and it is necessary to strictly control the indications.