双对比造影诊断上胃肠道肿瘤的价值再认识

Re-evaluation of the Value of Double-Contrast Barium Evamination in the Diagnosis of Upper Gastrointestinal Tumor

目的 :探讨双对比造影在当前医疗过程中是否对上胃肠道肿瘤仍为基本的诊断手段。材料和方法 :回顾性分析 1991～ 1997年来我院临床初诊为上消化道疾病并作双对比造影检查的 1184 0病例 ,其中胃镜及活检阴性的肿瘤 5 9例 ,评价双对比造影对上消化道肿瘤的诊断价值。结果 :检出肿瘤总数为 344 3人次 ,检出率 2 9 1% ,其中恶性肿瘤 3435例 ,占肿瘤的 99 7% ,包括食管癌 2 70 8例 (78 9% ) ,胃癌 70 1例 (2 0 % ) ,十二指肠空肠近段肿瘤 34例 (1% )。早癌 5 5例 ,检出率 1 6 % ,多重癌 17例 ,为 0 5 %。临床内镜及活检阴性的 5 9例肿瘤中 ,食管癌 17例 ,贲门癌 2 0例 ,浸润型胃癌 11例 ,溃疡性胃癌 5例 ,空肠癌 6例 ,其中被钡剂双对比检查诊断 5 7例 ,准确率 97 8%。结论 :双对比造影仍然是上胃肠道肿瘤敏感的诊断技术 ,尤其对粘膜下浸润、以管腔狭窄为主的病变以及胃贲门。

Objective:To evaluate the diagnostic value of double-contrast barium examination upper gastrointestinal tumor in current medical practice.Materials and Methods:A total of 11840 cases who had double-contrast barium examination of the upper gastrointestinal tract was retrospectively reviewed between 1991 to 1997.The tumors in the upper gastrointestinal tract were confirmed by pathology.The diagnostic value of double-contrast barium examination was evaluated.Results:A total of 3443(29 1%)tumors were diagnosed by double-contrast barium examination in 11840 patients.Malignant tumors were 3435(99 7%),including 2708(78 6%)esophageal carcinomas,701(20%)gastric carcinomas and 34(1%)duodeno-jejunal tumors.55(1 6%)early carcinomas and 17(0 5%)multiple cancers were diagnosed,respectively,and 59 tumors were misdiagnosed from gastroscopy and biopsy,located at the esophagus(17),stoma(20)and body(16)of stomach and proximal jejunum(6),however,57(97 8%)of them were identified from double-contrast barium examination.Conclusion:Double-contrast barium examination was still a sensitive measure diagnosis of the upper gastrointestinal tumors,especially for those stenosing and infiltrating lesions,as well as at the site of the stomas of stomach and proximal jejunum.