胃肠病学
胃腸病學
위장병학
Chinese Journal of Gastroenterology
2015年
9期
550-552
,共3页
内镜超声检查%胃间质瘤%肿瘤侵润%诊断
內鏡超聲檢查%胃間質瘤%腫瘤侵潤%診斷
내경초성검사%위간질류%종류침윤%진단
Endoscopic Ultrasonography%Gastric Stromal Tumors%Neoplasm Invasiveness%Diagnosis
背景：胃肠道间质瘤（GISTs）为具有潜在恶性的胃肠道间叶源性肿瘤，文献报道内镜超声检查（ EUS）的声像图特征有助于 GISTs 的早期诊断和侵袭危险性评估。目的：评价 EUS 诊断胃间质瘤和预测肿瘤侵袭危险性的价值。方法：纳入2010年1月-2014年4月南京鼓楼医院经内镜和 EUS 检查初步诊断为胃间质瘤的患者148例，其中103例经术后病理确诊为胃间质瘤。采集入组患者的内镜、EUS 和临床病理资料，分别根据 EUS 特征和组织病理学检查结果判断肿瘤侵袭危险性。结果：以病理诊断为金标准，EUS 诊断胃间质瘤的准确性为69.6%，误诊病例多为平滑肌瘤和神经鞘瘤。EUS 与组织病理学检查判断肿瘤侵袭危险性的符合率为77.7%，一致性检验κ=0.678（P =0.000）。结论：EUS 对胃间质瘤具有较高的诊断价值，并可作为预测肿瘤侵袭危险性的方法，为治疗方案的选择提供依据。
揹景：胃腸道間質瘤（GISTs）為具有潛在噁性的胃腸道間葉源性腫瘤，文獻報道內鏡超聲檢查（ EUS）的聲像圖特徵有助于 GISTs 的早期診斷和侵襲危險性評估。目的：評價 EUS 診斷胃間質瘤和預測腫瘤侵襲危險性的價值。方法：納入2010年1月-2014年4月南京鼓樓醫院經內鏡和 EUS 檢查初步診斷為胃間質瘤的患者148例，其中103例經術後病理確診為胃間質瘤。採集入組患者的內鏡、EUS 和臨床病理資料，分彆根據 EUS 特徵和組織病理學檢查結果判斷腫瘤侵襲危險性。結果：以病理診斷為金標準，EUS 診斷胃間質瘤的準確性為69.6%，誤診病例多為平滑肌瘤和神經鞘瘤。EUS 與組織病理學檢查判斷腫瘤侵襲危險性的符閤率為77.7%，一緻性檢驗κ=0.678（P =0.000）。結論：EUS 對胃間質瘤具有較高的診斷價值，併可作為預測腫瘤侵襲危險性的方法，為治療方案的選擇提供依據。
배경：위장도간질류（GISTs）위구유잠재악성적위장도간협원성종류，문헌보도내경초성검사（ EUS）적성상도특정유조우 GISTs 적조기진단화침습위험성평고。목적：평개 EUS 진단위간질류화예측종류침습위험성적개치。방법：납입2010년1월-2014년4월남경고루의원경내경화 EUS 검사초보진단위위간질류적환자148례，기중103례경술후병리학진위위간질류。채집입조환자적내경、EUS 화림상병리자료，분별근거 EUS 특정화조직병이학검사결과판단종류침습위험성。결과：이병리진단위금표준，EUS 진단위간질류적준학성위69.6%，오진병례다위평활기류화신경초류。EUS 여조직병이학검사판단종류침습위험성적부합솔위77.7%，일치성검험κ=0.678（P =0.000）。결론：EUS 대위간질류구유교고적진단개치，병가작위예측종류침습위험성적방법，위치료방안적선택제공의거。
Background:Gastrointestinal stromal tumors( GISTs) are mesenchymal tumors with potential malignancy in gastrointestinal tract. Some endoscopic ultrasonographic(EUS)features have been reported to be suggestive for GISTs and its invasive risk. Aims:To assess the value of EUS in diagnosis and prediction of invasive risk of gastric stromal tumors. Methods:A total of 148 cases of gastric stromal tumors preliminarily diagnosed by endoscopy and EUS between Jan. 2010 and Apr. 2014 at Nanjing Drum Tower Hospital were retrospectively recruited. Of them 103 were proved to be gastric stromal tumors by postoperative histopathology. The endoscopic,EUS and clinicopathological features were collected,and the risk of tumor invasiveness was estimated based on EUS and histopathological features,respectively. Results:Taken pathological diagnosis as gold standard,the diagnostic accuracy of EUS for gastric stromal tumors was 69. 6% ,and most of the misdiagnosis cases were leiomyoma and schwannoma. The coincidence rate of EUS and histopathology in classifying tumor invasive risk was 77. 7%,with a κ value of 0. 678(P = 0. 000)in consistency-checking test. Conclusions:An acceptable diagnostic performance can be achieved by using EUS for diagnosis of gastric stromal tumors. Furthermore,EUS can be used as a tool for prediction of invasive risk of gastric stromal tumors,and providing the basis for treatment regimen selection.
