超声内镜在胃肠道黏膜下良性病变诊断中的作用

目的：探讨超声内镜在诊断消化道良性病变中的临床应用价值。方法：应用奥林巴斯Q260和H260系列内镜检查348例消化道黏膜下病变，部分患者进行相应的内镜下活组织检查，统计内镜检查与病理检查结果符合率。结果：348例消化道黏膜下病变经超声内镜检查发现331例为良性病变或外压性改变，超声内镜诊断与病理诊断符合率分别为平滑肌瘤85．7％（48／56）；间质瘤82．6％（19／23）；息肉样变73．3％（11／15）；异位胰腺85．0％（17／20）；脂肪瘤100％（3／3）。发生部位依次为胃165例（49．8％）、食管79例（23．9％）、十二指肠50例（15．1％）、结肠26例（7．9％）、直肠11例（3．3％），未发现病变17例。病变性质依次为平滑肌瘤150例（45．3％）、囊肿54例（16．3％）、外压性改变37例（11．2％）、异位胰腺34例（10．3％）、间质瘤26例（7．9％）、息肉样变15例（4．5％）、血管瘤6例（1．8％）、脂肪瘤5例（1．5％）和脓肿4例（1．2％）。结论：超声内镜对消化道良性病变的诊断具有较高的临床应用价值。

Effect of endoscopic ultrasonography on diagnosis of submucosal nonmalignant lesions in gastrointestinal tract

Objective： To evaluate the effect of endoscopic ultrasonography on diagnosis of submucosal nonmalignant lesions in gastrointestinal tract. Methods： Endoscope of Olympus GF-UMG240 （7.5/12 MHz）, UM-2R （ 12 MHz） and UM-3R （20 MHz） were used to examine 348 patients with submucosal nonmalignant lesions, and the samples of endoscopic biopsy and endoscopic resection as well as surgical resection were pathologically examined. Results： In 348 cases, 331 cases were diagnosed as submucosal nonmalignant lesions, and other 17 cases were not observed lesion. In some lesions, the diagnostic coincidence rate of endoscopic ultrasonography were respectively leiomyoma 85.7% （48/56 cases）, GIST 82.6% （19/23 cases）, polyp 73.3% （11/15 cases）, ectopic pancreas 85.0% （17/20 cases） and lipoma100% （3/3 cases）, compared with pathologic examination. In 331 cases, the lesions were in stomach （ 165 cases, 49.8% ） , esophagus （79 cases, 23.9% ） , duodenum （50 cases, 15.1% ）, colon （26 cases, 7.9% ） , and rectum （ 11 cases, 3.3% ）, respectively. The pathological results showed that the submucosal nonmalignant lesions respectively were leiomyoma （150 cases, 45.3% ） , cyst （54 cases, 16.3% ）, external pressure （37 cases, 11.2% ）, ectopic pancreas （34 cases, 10. 3% ） , gastrointestinal stromal tumor （26 cases, 7. 9% ） , polyp （ 15 cases, 4.5% ） , angioma （6 cases, 1.8% ） , lipoma （5 cases, 1.5% ） and abscess （4 cases, 1.2% ）. Conclusion： Endoscopic ultrasonography is able to play an important role in diagnosis of submucosal nonmalignant lesions in gastrointestinal tract.