消化道颗粒细胞瘤21例的内镜治疗

Endoscopic treatment of 21 cases of gastrointestinal granular cell tumor

目的:探讨消化道颗粒细胞瘤(GCT)临床特点及内镜治疗的有效性和安全性。方法:回顾性分析2016年1月至2020年12月在郑州大学第一附属医院消化内镜中心行内镜治疗的21例消化道GCT患者的临床特点及内镜治疗效果。结果:21例消化道GCT位于食管15例、胃3例、回肠1例、结肠2例。所有患者均表现为非特异性的消化道症状,21例术前胃镜、19例术前超声内镜检查均观察到黏膜下隆起性病变,病灶直径均<2 cm。1例术前行活检,病理提示食管鳞状细胞癌。1例经内镜活检后烧灼清除;余20例均行内镜下切除,包括圈套切除10例、内镜下黏膜切除术7例、内镜黏膜下剥离术3例,术中、术后均无并发症发生。所有患者随访0.0~48.1个月,均未见肿瘤复发。结论:内镜切除是治疗消化道GCT的安全、有效手段,能够实现对病灶的完全切除,短期观察术后无复发,可作为消化道GCT患者的首选治疗手段。

Aim:To investigate the clinical characteristics of gastrointestinal granular cell tumor(GCT) and the efficacy and safety of endoscopic therapy.Methods:The clinical characteristics and endoscopic treatment effects of 21 patients with gastrointestinal GCT who underwent endoscopic treatment,in the Digestive Endoscopy Center of the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2020 were retrospectively analyzed.Results:Among the 21 patients with gastrointestinal GCT,15 were located in the esophagus,3 in the stomach,1 in the ileum,and 2 in the colon.All patients presented with non-specific gastrointestinal symptoms.Submucosal elevated lesion with diameter<2 cm were observed in 21 cases of preoperative gastroscopy and 19 cases of preoperative endoscopic ultrasonography.One case underwent preoperative biopsy,and histology showed esophageal squamous cell carcinoma.One case was cauterized after endoscopic biopsy;the remaining 20 cases underwent endoscopic resection,including 10 cases of snare resection,7 cases of endoscopic mucosal resection,and 3 cases of endoscopic submucosal dissection.No intraoperative or postoperative complications occurred.All patients were followed up for 0.0-48.1 months,and no tumor recurrence was observed.Conclusion:Endoscopic resection is a safe and effective method for the treatment of gastrointestinal GCT,which can achieve complete resection of the lesion and no recurrence during short-term observation.It can be the first choice for patients with gastrointestinal GCT.