食管颗粒细胞瘤的内镜表现及内镜治疗

Endoscopic manifestations and endoscopic treatments of esophageal granular cell tumors

目的探讨食管颗粒细胞瘤(GCTs)内镜特征及内镜治疗的有效性和安全性。方法选取2004年1月~2016年6月在福建省立医院消化内镜中心行内镜切除并经病理确诊的GCTs患者为研究对象,观察其临床表现,内镜、超声内镜检查特点以及内镜治疗方法,并分析其随访结果。结果共19例经病理确诊为食管GCTs的患者,其中男8例,女11例。年龄39~65岁,平均年龄(50.12±9.37)岁。内镜检查表现为黄白色隆起,表面光滑。超声内镜检查均为低回声改变。其中14例病变起源于黏膜层及黏膜肌层,5例病变起源于黏膜下层,病灶大小0.6~2.5 cm,平均(0.8±0.57)cm。其中16例患者行内镜黏膜切除术(EMR),3例患者行内镜黏膜下剥离术(ESD),无患者出现内镜治疗的相关并发症。术后随访7~144个月,中位随访时间为74个月,随访期间未见肿瘤复发和转移。结论内镜及超声内镜检查是食管GCTs的重要检查方法,EMR和ESD是食管GCTs安全有效的治疗方法。

Objective To investigate endoscopic features and the efficacy and safety of endoscopic treatments of esophageal granular cell tumors （GCTs）. Methods Patients with GCTs who were underwent endoscopic resection and confirmed by pathology in Gastrointestinal Endoscopy Center of Fujian Provincial Hospital from January 2004 to June 2016 were selected as the study object, testing results of endoscopy, endoscopic uhrasonography examination characteristics and endoscopic treatment were observed and follow-up results were analyzed. Results There were 19 patients with esophageal GCTs in this study,included 8 males and 11 females. The patients were between 39 and 65 years old, with an average age of （50.12±9.37） years old. The lesions exhibited yellowish or white lump with smooth surface in gastroscopy, all cases presented low echo changes in endoscopic uhrasonography.14 cases were derived from mucosa and muscularis mucosa, 5 cases were derived from submucosa, the diameters of these lesions were 0.6-3.0 cm with an average of （0.8±0.57） era. 16 cases of patients with endoscopic mucosal resection （EMR） and Three patients of endoscopic submucosal dissection （ESD）, no patient showed the complications associated with endoscopic therapy. The patients were followed up for 7-144 months, with the median of 74 months, no tumor recurrence or metastasis was observed during the follow-up period. Conclusion Endoscopy and endoscopic uhrasonography are important methods for the diagnosis of esophageal GCTs, EMR and ESD are safe and effective for the treatment of esophageal GCTs.