超声内镜检查在低增殖活性胃肠道神经内分泌肿瘤微创治疗中的价值

Evaluation of endoscopic ultrasonography in minimally invasive treatment of low-grade gastrointestinal neuroendocrine neoplasm

目的评价超声内镜(endoscopic ultrasonography,EUS)在低增殖活性胃肠道神经内分泌肿瘤(gastrointestinal neuroendocrine neoplasm,GI-NEN)微创治疗中的价值。方法回顾分析130例低增殖活性GINEN的内镜病理资料,所有病例均经病理及免疫组织化学明确诊断,所有病例均行胃镜检查发现瘤体,并行镜下微创治疗,其中行超声胃镜检查59例,直接镜下切除71例。所有病例进行内镜随访。结果 130例均行病理G分期:Gl期114例,G2期16例。其中对切除病理依术前EUS评估与否进行分组,非EUS评估组垂直切缘阳性率高于EUS评估组(P=0.03),而水平切缘阳性率两组间差异无统计学意义。随访结果中23例再次治疗病例均为多发病例。结论低增殖活性GI-NEN在EUS指导下选择合适的内镜切除方法,可以提高内镜完全切除率。多发低增殖活性GI-NEN内镜治疗复发率高,应严密随访。

Objective To evaluate the value of endoscopic ultrasonography in minimally invasive treatment of low-grade gastrointestinal neuroendocrine neoplasm.Methods The endoscopic and pathological data of 130 cases of neuroendocrine tumors of the stomach in our hospital were analyzed retrospectively.All cases were examined and found the tumor body by gastroscopy and the diagnosis was confirmed by immunohistochemistry,minimally invasive endoscopic treatment,in which 59 cases were treated by endoscopic ultrasonography,and 71 cases were removed by direct microscopy.Results All 130 cases diagnozed by pathology G grade,incoluded G1 114 cases,G2 16 cases.The patients were divided into two groups according to the preoperative evaluation of endoscopic ulrasonography（EUS）.The positive rate of vertical cutting edge in the group without EUS evaluation was higher than that in EUS group（P =0.03）,but there was no significant difference in horizental edge positive between two groups.Follow-up results showed that 23 cases of retreatment were all multiple cases.Conclusion Endoscopic resection of low-grade gastrointestinal neuroendocrine neoplasm is a safe and effective method to improve endoscopic resection rate,and the prognosis is good.