超声内镜在上消化道黏膜下肿瘤诊断和鉴别诊断中的价值

目的:分析超声内镜(EUS)在上消化道黏膜下肿瘤(SMT)诊断价值。方法:选取我院收治的SMT患者81例,均进行EUS检查,且在院内进行内镜,或者手术治疗,将EUS诊断结果与术后的病理结果进行对比分析。结果:本组87处病变,经EUS诊断结果显示,平滑肌瘤35处,间质瘤36处,异位胰腺6处,脂肪瘤6处,类癌1处,囊肿1处,2处未做明确的诊断。经计算,EUS诊断SMT的阳性预测值79.31%,其中平滑肌瘤阳性预测值94.29%,间质瘤阳性预测值69.44%,异位胰腺阳性预测值83.33%,脂肪瘤阳性预测值66.67%。与术后病理诊断结果不符的EUS诊断病变共18处,诊断错误率20.69%,食管病变7处,胃病变10处,十二指肠病变1处。结论:EUS对上消化道SMT的诊断效果总体令人满意,但需要注意鉴别诊断,提高诊断准确率。

Value of Endoscopic Ultrasonography in the Diagnosis and Differential Diagnosis of Submucosal Tumors in Upper Gastrointestinal Tract

ABSTRACT Objective: To analyze the diagnostic value of endoscopic ultrasonography (EUS) for submucosal tumors in upper gastrointestinal tract (SMT). Methods: 81 SMT patients in our hospital were selected and examined by EUS. All patients received endoscopy or surgery in the hospital. The EUS diagnosis results and postoperative pathological results were compared and analyzed. Results: EUS diagnosis showed that among all 87 lesions, there were 35 leiomyoma, 36 stromal tumors, 6 heterotopic pancreas, 6 lipoma, 1 carcinoid, 1 cysts, 2 without definite diagnosis. Through calculation, the positive predictive value of EUS in diagnosing SMT was 79.31%, and the value for leiomyoma was 94.29% stromal tumor 69.44%, ectopic pancreas 83.33%, and lipoma 66.67%. Altogether 18 lesions did not accord with postoperative pathological results, and the diagnostic error rate was 20.69%. Among the 18 lesions, there were 7 esophageal lesions, 10 gastropathy, 1 duodenal disease at the junction. Conclusion: The diagnostic effect of EUS on upper gastrointestinal tract SMT is satisfactory, but we still need to pay attention to differential diagnosis and improve the accuracy of diagnosis.