中华消化病与影像杂志（电子版）
中華消化病與影像雜誌（電子版）
중화소화병여영상잡지（전자판）
2014年
4期
175-178
,共4页
消化系统肿瘤%上胃肠道%内窥镜检查,消化系统%固有肌层
消化繫統腫瘤%上胃腸道%內窺鏡檢查,消化繫統%固有肌層
소화계통종류%상위장도%내규경검사,소화계통%고유기층
Digestive system neoplasms%Upper gastrointestinal tract%Endoscopy,digestive system%Muscularis propria
目的：探讨三种常见的内镜治疗方法对于起源于固有肌层的上消化道肿瘤的治疗价值。方法通过胃镜及超声内镜筛选出2011至2013年共70例患有上消化道固有肌层肿瘤的病例，根据肿瘤的位置及深度采用三种常见的内镜治疗方法给予切除。三种方法是：内镜黏膜下挖除术（ESE），内镜全层切除术（ EFR），内镜经黏膜下隧道肿瘤切除术（STER）。切除肿瘤术后均经免疫组化及分子生物学等相关病理检测，检测指标为CD34、CD117、Dog-1、S-100、平滑肌肌动蛋白（ SMA）、Ki-67以及核分裂数。结果共有35例患者接受ESE治疗，其中2例出现穿孔，通过钛夹修补；27例接受STER治疗，未出现穿孔并发症；8例接受EFR治疗，均有“人工”穿孔，通过钛夹完全修补。所有70例经过治疗后均完全康复，未追加外科手术治疗。结论上消化道固有肌层肿瘤可通过内镜治疗成功切除，可逐步替代外科手术治疗，且有更大的应用范围。
目的：探討三種常見的內鏡治療方法對于起源于固有肌層的上消化道腫瘤的治療價值。方法通過胃鏡及超聲內鏡篩選齣2011至2013年共70例患有上消化道固有肌層腫瘤的病例，根據腫瘤的位置及深度採用三種常見的內鏡治療方法給予切除。三種方法是：內鏡黏膜下挖除術（ESE），內鏡全層切除術（ EFR），內鏡經黏膜下隧道腫瘤切除術（STER）。切除腫瘤術後均經免疫組化及分子生物學等相關病理檢測，檢測指標為CD34、CD117、Dog-1、S-100、平滑肌肌動蛋白（ SMA）、Ki-67以及覈分裂數。結果共有35例患者接受ESE治療，其中2例齣現穿孔，通過鈦夾脩補；27例接受STER治療，未齣現穿孔併髮癥；8例接受EFR治療，均有“人工”穿孔，通過鈦夾完全脩補。所有70例經過治療後均完全康複，未追加外科手術治療。結論上消化道固有肌層腫瘤可通過內鏡治療成功切除，可逐步替代外科手術治療，且有更大的應用範圍。
목적：탐토삼충상견적내경치료방법대우기원우고유기층적상소화도종류적치료개치。방법통과위경급초성내경사선출2011지2013년공70례환유상소화도고유기층종류적병례，근거종류적위치급심도채용삼충상견적내경치료방법급여절제。삼충방법시：내경점막하알제술（ESE），내경전층절제술（ EFR），내경경점막하수도종류절제술（STER）。절제종류술후균경면역조화급분자생물학등상관병리검측，검측지표위CD34、CD117、Dog-1、S-100、평활기기동단백（ SMA）、Ki-67이급핵분렬수。결과공유35례환자접수ESE치료，기중2례출현천공，통과태협수보；27례접수STER치료，미출현천공병발증；8례접수EFR치료，균유“인공”천공，통과태협완전수보。소유70례경과치료후균완전강복，미추가외과수술치료。결론상소화도고유기층종류가통과내경치료성공절제，가축보체대외과수술치료，차유경대적응용범위。
Objective To explore the therapeutic value of three common endoscopic therapy methods for upper gastrointestinal tumors originating from the muscularis propria .Methods For 70 cases diagnosed as muscularis propria tumor of upper gastrointestinal tract revealed in the examinations of gastroendoscope and ultrasound gastroendoscope from 2011 to 2013 , three types of endoscopic therapy methods were selected , based on the location and depth of the tumor .These methods included endoscopic submucosal excavation ( ESE ) , endoscopic full-thickness resection ( EFR ) and submucosal tunneling endoscopic resection(STER).Immunohistochemistry and molecular biology for CD34,CD117,Dog-1,S-100, smooth muscle actin ( SMA ) , Ki-67 and mitotic count were performed on the resected tumors .Results A total of 35 cases were treated with ESE ,2 cases were complicated by perforation , and the perforations were closed with metal clips.Additionally,27 cases were treated with STER,and no perforation occurred.Finally,8 cases were treated with EFR , all of the cases were complicated by artificial perforation , and all of the perforations were closed with metal clips .All of the 70 cases recovered with medical treatment , and none required surgical operation .Immunohistochemistry and molecular biology demonstrated that among all of the 70 cases, 29 cases were gastric stromal tumors , and the other 41 cases were gastric leiomyomas . Conclusions Muscularis propria tumor of upper gastrointestinal tract can be treated successfully with endoscopic techniques ,which could replace certain surgical operations and should be considered for further application .
