粤北地区大肠黏膜下肿物超声内镜诊断与内镜黏膜下剥离术后病理结果的对比研究

Comparative Study of Ultrasonic Endoscope Diagnosis of Large Intestine Submucosal Masses and Pathological Results after Endoscopic Submucosal Dissection in Northern Guangdong Province

目的:探讨粤北地区大肠黏膜下肿物超声内镜诊断结果与内镜黏膜下剥离术(ESD)后病理结果的差异,为大肠黏膜下肿物的早期诊断与手术方案设计提供帮助。方法:回顾性分析2017年11月—2023年9月于粤北人民医院行超声内镜检查及ESD治疗的91例大肠黏膜下肿物患者的临床资料。评估记录病变大小、病变起源、病变类型,根据术中观察和ESD后病理结果,评价术前超声内镜检查的准确率,并进行一致性分析。结果:91例患者,术前超声内镜检查诊断病变类型的准确率为90.11%(82/91),超声内镜诊断与病理诊断的Kappa值为0.514,一致性好;术前超声内镜检查诊断病变大小的准确率为93.41%(85/91),超声内镜诊断与ESD诊断的Kappa值为0.771,一致性极好;术前超声内镜诊断病变起源的准确率为93.41%(85/91),超声内镜诊断与病理诊断的Kappa值为0.781,一致性极好。结论:粤北地区超声内镜诊断大肠黏膜下肿物的准确率较高,可为内镜下治疗提供较为准确的依据。

Objective:To explore the difference between ultrasonic endoscope diagnosis results and pathological results after endoscopic submucosal dissection(ESD)of large intestine submucosal masses in northern Guangdong Province,and to provide help for early diagnosis and surgical plan design of large intestine submucosal masses.Method:The clinical data of 91 patients with large intestine submucosal masses who underwent ultrasonic endoscope examination and ESD treatment in Yuebei People's Hospital from November 2017 to September 2023 were retrospectively analyzed.The size,origin and type of lesions were evaluated and recorded.The accuracy rate of preoperative ultrasonic endoscope examination was evaluated according to intraoperative observation and pathological results after ESD,and the consistency analysis were performed.Result:In 91 patients,the accuracy rate of preoperative ultrasonic endoscope examination in the diagnosis of pathological types was 90.11%(82/91),and the Kappa value of ultrasonic endoscope diagnosis and pathological diagnosis was 0.514,showing good consistency.The accuracy rate of preoperative ultrasonic endoscope examination in the diagnosis of lesion size was 93.41%(85/91),and the Kappa value of ultrasonic endoscope diagnosis and pathological diagnosis was 0.771,showing excellent consistency.The accuracy rate of preoperative ultrasonic endoscope examination in the diagnosing of lesions origin was 93.41%(85/91),and the Kappa value of ultrasonic endoscope diagnosis and pathological diagnosis was 0.781,showing excellent consistency.Conclusion:The accuracy of ultrasonic endoscope in the diagnosis of large intestine submucosal masses is relatively high in northern Guangdong Province,which can provide a more accurate basis for endoscopic treatment.