中华消化内镜杂志
中華消化內鏡雜誌
중화소화내경잡지
CHINESE JOURNAL OF DIGESTIVE ENDOSCOPY
2011年
12期
675-679
,共5页
夏璐%李晓露%程吉华%孙蕴伟%谭继宏%龚婷婷%胡端敏%赵东幸%吴珺玮%叶廷军%诸琦
夏璐%李曉露%程吉華%孫蘊偉%譚繼宏%龔婷婷%鬍耑敏%趙東倖%吳珺瑋%葉廷軍%諸琦
하로%리효로%정길화%손온위%담계굉%공정정%호단민%조동행%오군위%협정군%제기
腔内超声检查%细针穿刺抽吸术%胃壁增厚
腔內超聲檢查%細針穿刺抽吸術%胃壁增厚
강내초성검사%세침천자추흡술%위벽증후
Endosonography%Fine needle aspiration%Thickness of gastric wall
目的 评价超声内镜对常规内镜活检阴性胃壁增厚病变的诊断价值.方法 回顾性分析57例常规内镜活检阴性胃壁增厚病变行超声内镜检查患者的诊断结果和随访情况,以手术病理和随访结果为最终诊断,统计内镜超声检查术(EUS)的诊断符合率以及内镜超声引导下细针穿刺抽吸术(EUS-FNA)、内镜超声定位下活检的阳性发现率.结果 57例最终诊断为胃癌19例、胃淋巴瘤10例、不典型增生1例、Menetrier's病1例、炎性改变26例.EUS对胃癌的诊断符合率为53.8％( 14/26),对胃淋巴瘤的诊断符合率为50.0％ (10/20):EUS-FNA阳性发现率为47.4％ (9/19);内镜超声定位下活检阳性发现率为66.7％ (20/30).结论 EUS结合EUS-FNA尚不能作为鉴别诊断常规内镜活检阴性胃壁增厚病变病因的金标准,但超声内镜对诊断有一定帮助.
目的 評價超聲內鏡對常規內鏡活檢陰性胃壁增厚病變的診斷價值.方法 迴顧性分析57例常規內鏡活檢陰性胃壁增厚病變行超聲內鏡檢查患者的診斷結果和隨訪情況,以手術病理和隨訪結果為最終診斷,統計內鏡超聲檢查術(EUS)的診斷符閤率以及內鏡超聲引導下細針穿刺抽吸術(EUS-FNA)、內鏡超聲定位下活檢的暘性髮現率.結果 57例最終診斷為胃癌19例、胃淋巴瘤10例、不典型增生1例、Menetrier's病1例、炎性改變26例.EUS對胃癌的診斷符閤率為53.8％( 14/26),對胃淋巴瘤的診斷符閤率為50.0％ (10/20):EUS-FNA暘性髮現率為47.4％ (9/19);內鏡超聲定位下活檢暘性髮現率為66.7％ (20/30).結論 EUS結閤EUS-FNA尚不能作為鑒彆診斷常規內鏡活檢陰性胃壁增厚病變病因的金標準,但超聲內鏡對診斷有一定幫助.
목적 평개초성내경대상규내경활검음성위벽증후병변적진단개치.방법 회고성분석57례상규내경활검음성위벽증후병변행초성내경검사환자적진단결과화수방정황,이수술병리화수방결과위최종진단,통계내경초성검사술(EUS)적진단부합솔이급내경초성인도하세침천자추흡술(EUS-FNA)、내경초성정위하활검적양성발현솔.결과 57례최종진단위위암19례、위림파류10례、불전형증생1례、Menetrier's병1례、염성개변26례.EUS대위암적진단부합솔위53.8％( 14/26),대위림파류적진단부합솔위50.0％ (10/20):EUS-FNA양성발현솔위47.4％ (9/19);내경초성정위하활검양성발현솔위66.7％ (20/30).결론 EUS결합EUS-FNA상불능작위감별진단상규내경활검음성위벽증후병변병인적금표준,단초성내경대진단유일정방조.
Objective To evaluate the accuracy of EUS,EUS-guided fine needle aspiration ( EUSFNA) and targeted biopsy in the diagnosis of wall-thickened gastric lesions with negative malignant results of endoscopic biopsies.Methods A retrospective study was carried out in 57 patients who were found with thickened gastric wall of negative malignant endoscopic biopsies and underwent EUS from January 2008 to December 2010 in our hospital.Compared the EUS findings with the surgical results and follow-up status.The diagnostic yield of EUS was characterized by the disappearance of the layers or the changes of thickness of gastric wall,the characteristics of echo imaging,and the results of EUS-FNA or EUS targeted biopsy were recorded to evaluate the value of EUS.Results Of 57 cases,gastric cancer was confirmed in 19,lymphoma in 10,dysplasia in 1,Menetrier's disease in 1 and inflammatory changes in 26.EUS could clearly demonstrate the changes of gastric wall including the thickness and the changes of layers,with the accuracy rate of 73.07％ ( 14/19 ) on gastric cancer.EUS diagnosed gastric cancer in 26 cases,in which 14 (53.8％) were confirmed by pathology.Gastric lymphoma was suspected by EUS in 20 cases,in which 10 (50.0％ ) were proved.EUS-FNA was conducted in 19 cases,with positive result in 9 (accuracy rate 50％ ).EUS-guided targeted deep biopsy or piece-meal biopsy were performed in 10 cases,with 8 malignant results.Conclusion EUS with/without EUS-FNA is not a golden standard for the diagnosis of gastric lesions in thickened gastric wall,yet it still has some significance.
