超声内镜诊断老年食管黏膜下肿瘤的准确性

目的探讨超声内镜诊断老年食管黏膜下肿瘤（SMTs）的准确性及价值。方法选择胃镜检查中存在食管黏膜下肿物的老年患者116例进行内镜超声检查（EUS），其中29例通过超声内镜引导细针穿刺（EUS—FNA）对肿瘤实施针吸活检，获得穿刺物临床病理珍断；14例通过手术获得术后临床病理诊断；将EUS诊断与病理诊断进行同一样本对照。结果在43例具有明确病理诊断的老年食管黏膜下肿物中，EUS诊断平滑肌瘤27例，平滑肌肉瘤4例，脂肪瘤3例，纵隔肿瘤6例，转移性淋巴结2例，淋巴结结核1例；病理诊断平滑肌瘤25例，平滑肌肉瘤6例，脂肪瘤3例，肺癌4例，淋巴瘤1例；转移性淋巴结3例，淋巴结结核1例。二者总符合率74．42％，其中食管壁内肿瘤诊断符合率94．12％，纵隔病变诊断符合率33．33％。结论通过EUS超声影像能够准确诊断老年食管壁内肿物的性质，纵隔肿瘤需根据EUS—FNA进行诊断。     

微探头超声内镜指导内镜下剥离联合圈套结扎治疗上消化道固有肌层肿瘤的初探

目的探讨微探头超声内镜指导内镜下剥离联合圈套结扎治疗来源于上消化道固有肌层黏膜下肿瘤（SMT）的疗效和安全性。方法对内镜发现的上消化道SMT行EUS,对其中来源于固有肌层的SMT行圈套结扎后应用针形切开刀行对应内镜下剥离治疗：内镜下圈套结扎病变;预切开病变表面中央的黏膜;剥离黏膜下层组织显露病变,完整切除病变。结果来源于上消化道固有肌层的SMT共13例,术后病理诊断为食管平滑肌瘤2例,胃平滑肌瘤3例,胃间质瘤7例,胃血管球瘤1例。病变直径0．8～1．5cm,平均1．2cm。13例病变均一次性完整切除,其中1例术后出现消化道穿孔,应用金属夹成功封闭,未转外科手术。结论微探头超声内镜指导内镜下剥离联合圈套结扎治疗来源于上消化道固有肌层直径≤1．5cm的SMT是安全、有效的,可完整切除病变,提供完整的病理学诊断资料,可达到与外科手术同样的治疗效果。     

超声内镜辅助内镜黏膜切除术治疗食管黏膜肌层病变的临床分析

目的回顾分析内镜下黏膜切除术(endoscopic mucosal resection,EMR)对食管黏膜肌层病变的治疗效果,并讨论其并发症和随访结果。方法 40例经超声内镜小探头证实的食管黏膜肌层病变,以注射法行黏膜切除治疗,记录病变大小、超声所见、操作方法、并发症、术后病理类型及随访情况。结果 40处病变经EMR完整切除,一次性完整切除率95.0%(38/40)。并发症:术中创面少许渗血7例(17.5%),均以氩气刀止血成功,无搏动性出血及穿孔发生。无迟发性出血及穿孔发生。术后病理:平滑肌瘤32例,间质瘤3例,炎性肉芽肿3例,血管瘤2例。随访1～12个月,未见病变残留或复发。结论超声内镜联合内镜黏膜切除术,术后常规行免疫组化检查,可完整切除食管黏膜肌层病变,方法安全有效。     

高频小探头超声辅助的内镜下黏膜切除术治疗消化道肿瘤的价值

目的探讨高频小探头超声辅助的内镜下黏膜切除术(EMR)治疗消化道肿瘤的安全性和疗效。方法在高频小探头超声辅助下采用EMR治疗直径0．5～3．5cm的胃肠道肿瘤30例，严密观察有无出血、穿孔等并发症，切除组织全部送组织病理学检查，术后定期门诊随访。结果EMR治疗成功率93．3％，瘤性病变完全切除率95．2％，癌性病变完全切除率85．7％，无一例出现大出血、穿孔等严重并发症，随访2～13个月均未见肿瘤复发。结论高频小探头超声辅助的EMR治疗早期细小消化道肿瘤是一项安全、有效的方法。     

内镜下超声微探头在诊治消化道黏膜下隆起病变的作用

目的探讨超声微探头（MPS）对消化道黏膜下隆起病变的诊断正确率和MPS提供的诊断资料对内镜医师选择治疗方式的参考价值。方法对消化道黏膜下隆起病变进行内镜下超声微探头检查，根据隆起的大小、件质和存管壁的层次等超声资料来诊断黏膜下隆起病变并选择切除方法。结果在24例患者中，对MPS诊断位于黏膜下层以上的直径小于2cm的消化道黏膜下肿块11例（良性问质瘤2例，脂肪瘤3例，囊肿5例，食管颗粒细胞瘤1例）采用内镜下治疗（黏膜切除术、氩离子体凝固治疗），无出血、穿孔并发症对于MPS诊断直径2cm以上或位于固有肌层以下的消化道黏膜下肿块13例（恶性胃肠道间质瘤4例，良性胃肠道问质瘤6例，脂肪瘤1例，异位胰腺2例）行外科手术。其超声诊断与病理诊断结果相一致。结论MPS可诊断黏膜下隆起的大小、层次和性质，有助于选择适应内镜下治疗的黏膜下隆起病例，内镜下治疗位于黏膜下层以内直径小于2cm的消化道黏膜下肿块SMT是安全、有效的方法。     

内镜超声检查在上消化道黏膜下肿瘤微创治疗中的价值研究

目的评价超声内镜检查对上消化道黏膜下肿瘤的诊断价值及指导内镜下微创治疗黏膜下肿瘤的疗效及安全性。方法经超声内镜诊断上消化道黏膜下肿瘤82例,根据黏膜下肿瘤的起源层次、大小及性质分别选择不同的内镜治疗方案,内镜治疗包括高频电凝电切术、内镜下黏膜切除术、皮圈套扎术等。标本行常规病理学及免疫组化检查。术后定期内镜随访。结果26例超声判断起源于黏膜肌层的上消化道黏膜下肿瘤行高频电凝电切术;17例起源于黏膜肌层的平坦型上消化道黏膜下肿瘤行内镜下黏膜切除术;38例起源于固有肌层和1例起源于黏膜肌层的上消化道黏膜下肿瘤行皮圈套扎术。内镜超声诊断与术后病理符合率为91．4％。术后1例出血,其余无严重并发症发生。79例术后随访3—24个月无复发。结论超声内镜能够对消化道黏膜下肿瘤进行起源和定性诊断,超声内镜为内镜微创治疗选择消化道黏膜下肿瘤适应证具有良好的指导作用,内镜治疗是消化道黏膜下肿瘤治疗的安全、有效的手段。     

超声内镜引导下Trucut穿刺活检诊断上消化道黏膜下肿瘤的初步经验

目的评估超声内镜引导下Trucut穿刺活检技术(EUS-TCB)对消化道黏膜下肿瘤穿刺活检的有效性及安全性。方法回顾性分析EUS-TCB对12例患者上消化道黏膜下肿瘤的穿刺活检,其中食管黏膜下肿瘤4例,胃黏膜下肿瘤6例,十二指肠黏膜下肿瘤2例。行超声内镜检查及其引导下的Trucut穿刺活检,穿刺获取的组织标本通过免疫组化染色等进行病理组织学检查,并观察穿刺部位的出血状况。结果对12例黏膜下病灶共穿刺36次,30次(83．3%)成功获取组织条块,6次(16．7%)穿刺未取得有效组织；7次(23．3%)穿刺获得的组织为片段状碎块,23次(76．7%)为完整的条状组织。病理检查证实食管鳞癌1例,食管平滑肌瘤3例,胃间质瘤4例,胃平滑肌瘤1例,胃癌(印戒细胞癌)1例,十二指肠降段间质瘤1例。无严重并发症发生。结论超声内镜引导下Trucut穿刺活检诊断上消化道黏膜下肿瘤安全、有效,可获得满意的病理组织,对十二指肠黏膜下肿瘤的诊断效果尚待进一步研究。     

43例食管黏膜下隆起性病变的临床、内镜及病理分析

目的探讨食管黏膜下隆起性病变的临床,内镜及病理特点。方法对43例食管隆起性病变患者均采用FUJIONEG-450型胃镜,OlympusUM-2R超声微探头检查及治疗。超声频率为7.5MHz～12MHz,高频电发生器为ERBE-200型。结果常规内镜发现隆起性病变位于食管上段5例,中段22例,下段16例。超声内镜提示间叶源性肿瘤40例,脂肪瘤3例。病灶位于黏膜肌层25例,黏膜下层18例。所有隆起性病变高频电切除后行"全瘤"活检。病理结果显示平滑肌瘤29例,间质瘤8例,脂肪瘤3例,神经纤维瘤2例,神经鞘瘤1例。43例患者半年至一年复查均痊愈,无复发。结论在超声引导下对小于2cm的食管黏膜下隆起性病变行高频电切除术,是安全有效的内镜微创技术。     

高频超声小探头引导内镜下切除消化道表浅隆起性病变

目的 探讨经内镜高频超声小探头引导内镜下黏膜切除术治疗消化道表浅隆起性病变的安全性、可行性.方法 对普通内镜下发现的67例消化道表浅隆起性病变,经内镜活检钳道插入高频超声小探头进行检查,对其中39例显示病变来源于黏膜层、黏膜肌层及黏膜下层的病变行内镜下黏膜切除术.切除的病变送病理检查.结果 16例消化道息肉、2例异位胰腺、14例间质瘤、3例脂肪瘤,3例类癌,1例早期胃癌共39例病变内镜下完全切除.操作过程顺利,其中一例出现术后迟发性出血,给予内镜下成功止血,无其他严重并发症出现,病理符合率87.1%.结论 高频超声小探头检查可初步明确病变来源及层次,安全有效地指导消化道表浅隆起性病变黏膜切除术治疗.     

内镜下套扎联合电切法治疗食管黏膜下肿瘤的临床应用

食管黏膜下肿瘤是食管常见的隆起性病变,种类较多,单纯常规内镜下检查有些病灶无法确定起源深度,不利于进一步选择治疗方案。近年来随着超声内镜的广泛应用及内镜技术的发展,食管黏膜下肿瘤的起源层次得到了明确的诊断,对选择治疗有一定帮助。2011年4月至2013年2月,我们通过小探头超声检查剔除固有肌层起源的食管黏膜下肿瘤,采取橡皮圈套扎加电切术来处理起源于黏膜肌层或黏膜下层的食管黏膜下肿瘤,取得较好的疗效。     

上消化道异位胰腺内镜诊治价值

目的探讨上消化道异位胰腺胃镜和超声内镜下的表现及内镜下治疗价值。方法回顾性分析2004年3月至2009年11月间经病理结果证实为上消化道异位胰腺的67例患者的临床资料,总结其临床症状、内镜和超声内镜下表现以及内镜下治疗结果。结果67例异位胰腺患者中,病灶多见于胃窦部（占92．5％,62／67）,其他还可见于胃角、十二指肠等处。胃镜下表现为隆起于胃壁的表面光滑的黏膜下肿物,顶部可有脐样凹陷。有59例患者在内镜治疗前接受了超声内镜检查,病灶在超声内镜下表现为累及管壁第2和第3层为主的回声不均、边界不清的以混合回声为主的病变,部分还可累及第1层和第4层。EMR切除60例,其中25例术后见基底残留,尤以累及第4层的病变为著（占92．0％,23／25）;只有1例病变术后第3天出现残基出血,其余病例均无明显出血等并发症发生。ESD切除的8例（包括1例曾先行EMR治疗的患者）,病变均完整切除,均未出现穿孔等严重并发症。术后病理结果显示,术前超声检查判断病变起源总符合率为91．5％（54／59）。结论胃镜结合超声内镜检查是判断上消化道异位胰腺范围及指导治疗的重要手段。未累及固有肌层时,EMR是最佳选择,特别是透明帽辅助法EMR;累及第4层时,宜采用ESD或随访观察。     

Preliminary assessment of miniprobe sonography in the diagnosis of gastric varices and evaluation of treatment with Histoacryl

OBJECTIVE : In comparison with conventional endoscopy, the clinical value of miniprobe sonography (MPS) was assessed both in the diagnosis of gastric varices (GV) and in the evaluation of its treatment with the tissue adhesive agent Histoacryl. METHODS : Twelve patients with liver cirrhosis and portal hypertension caused by hepatitis B in nine cases and hepatitis C in three cases were examined by MPS to verify the presence of gastric fundic varices before and after endoscopic treatment with Histoacryl. Curative efficacy of Histoacryl treatment was defined by the finding of variceal lumen obliteration characteristics in the ultrasonic image. RESULTS : Gastric fundic varices were detected in 10 patients by using MPS, however, only seven cases were detected by using conventional macroscopic examination. For gastric fundic varices, the diagnostic accuracies of standard endoscopy and MPS were 75% (9/12) and 100% (12/12), respectively. Furthermore, MPS was able to produce a practical ultrasonic image of complete or incomplete variceal vessel lumen obliteration for use in the assessment of the efficacy of endoscopic treatment with Histoacryl. CONCLUSIONS : Miniprobe sonography was found to be significantly superior to conventional macroscopic diagnosis in both the detection of fundic varices and the evaluation of the efficacy of endoscopic therapy. Moreover, MPS could play an important role in follow up and in evaluation of the need for further treatment. Therefore, MPS appears to be a safe and very useful clinical technique in evaluating patients with portal hypertension with respect to the detection of fundic varices and may help in selecting patients for appropriate therapy.     

Source of errors in the evaluation of early rectal cancer by endoluminal ultrasonography

PURPOSE: Although preoperative evaluation of early rectal cancers can be done by endoluminal sonography and by means of colonoscopic findings, it is still controversial whether endoluminal sonography can effectively discriminate mucosal from submucosal lesions. This study was performed to verify objective causes of errors in the evaluation of early rectal cancer (T0/1) using a review of videotaped endoluminal sonography images. METHODS: Eighty-nine patients with suspected early rectal cancer on endoluminal sonography were included. Two different scanners with appropriate probes were used according to tumor location, i.e., transrectal ultrasonography was used to scan up to 8 cm of the rectum above the anal verge, whereas endoscopic ultrasonography was used to assess higher lesions. Endoluminal sonography images were correlated with histologic infiltration and were reevaluated carefully to identify sources of errors. RESULTS: Sensitivity and specificity were 83.1 and 96.5 percent, respectively, for tumor staging, whereas sensitivity was very low compared with specificity (16.7 vs. 90.2 percent) for metastatic lymph nodes. Endoluminal sonography images showed irregularity of the underlying tumor border (P < 0.01) and hypoechoic blurring or cutoff of the inner and outer hypoechoic layers (P < 0.001), all of which closely correlated with histologic infiltration of tumor cells. Overstaging occurred more than twice as often as understaging in tumor reevaluation (14 vs. 5 occurrences). In contrast to tumors, lymph nodes showed a similar amount of both overstaging (four cases) and understaging (five cases). The sources of errors were summarized as five types: false instrumentation, interpretive errors, anatomic defects, imaging failure, and inevitable errors. CONCLUSIONS: Because false instrumentation, interpretive errors, and anatomic defects were considered preventable, 23 (82.1 percent) of the 28 errors might have been avoided. Therefore, a clear image by endoluminal sonography can effectively distinguish mucosal from submucosal lesions in early rectal cancer.     

Intrabiliary rupture of hepatic hydatid cyst: sonographic and cholangiographic appearances.

Sonographic and cholangiographic appearances of confirmed intrabiliary rupture of a hepatic hydatid cyst were studied in 15 cases. Sonographic findings included liver cyst in all cases; nonshadowing echogenic structures in the dilated biliary tree representing hydatid material, such as fragmented membranes, sand, matrix, and daughter vesicles, in eight cases; and loss of continuity of the cyst wall adjacent to the bile duct representing the site of communication in seven cases. Cholangiographic findings were as follows: filling defects of varying size and shapes in the dilated biliary tree in 13 cases, and changing shape and position of these filling defects in three of them; and leakage of contrast medium into the cyst cavity in 12 cases. Intrabiliary rupture of hepatic hydatid cyst was suggested by sonography in 10 cases (66.7%) and at cholangiography in 13 cases (86.6%). We conclude that a joint application of sonography and endoscopic cholangiography is mandatory for proper preoperative evaluation of this disorder.     

Clinical outcome of endoscopic mucosal resection for superficial GI lesions and the role of high-frequency US probe sonography in an American population

BACKGROUND: Endoscopic mucosal resection, a major advance in endoscopy, provides an endoscopic option for management of focal and superficial lesions of the gastrointestinal tract. Although popular in the Orient due to the high incidence of superficial neoplasia, there are scant data on its use in the United States. Our aim was to assess the efficacy and safety of endoscopic mucosal resection in our patient population and evaluate whether high-frequency ultrasound (US) probe sonography provides useful information relative to the procedure. METHODS: Endoscopic mucosal resection was performed in 32 of 33 patients referred for endoscopic management of superficial neoplastic or submucosal lesions. High-frequency US probe sonography was performed with a 20 MHz US probe. Endoscopic mucosal resection was performed after submucosal saline solution injection with the strip biopsy technique. RESULTS: Thirty-two superficial lesions were resected. Of 24 epithelial lesions resected, 22 were intramucosal and 2 had early submucosal invasion (SM1); the 2 patients with the latter 2 lesions were poor candidates for surgery. Depth of penetration of 25 of 26 lesions scanned was accurately predicted by high-frequency US probe sonography. Eight lesions raised from the submucosa. Minor complications were limited to the colon. Of the 7 patients with carcinomas, 6 had no evidence of recurrence at a mean follow-up of 12 months; 1 died of a second primary cancer. CONCLUSIONS: Endoscopic mucosal resection provided definitive therapy for 24 early-stage neoplastic lesions and provided a diagnosis in the remaining 8. In our study, the technique proved to be safe with only three minor complications noted. High-frequency US probe sonography accurately delineated the depth of penetration of all lesions scanned, therefore making it an ideal imaging modality for selecting patients who may benefit from endoscopic mucosal resection.     

胰管结石的诊断和治疗(附35例临床分析)

目的探讨胰管结石的诊断和治疗方法。方法回顾性分析过去10余年问治疗的35例胰管结石患者的临床资料。结果全部35例中33例出现持续性左上腹痛伴左腰背部放射痛,上腹部压痛25例。35例均行B型超声检查,诊断阳性率为88.57%(31/35);23例行腹部CT检查,诊断阳性率为78.26%(18/23);19例行逆行胰胆管造影检查,诊断阳性率为100%(19/19);19例行磁共振胰胆管成像检查,诊断阳性率为94.73%(18/19)。患者分别采用手术治疗和内镜治疗。手术治疗16例,采用的术式包括胰管切开取石、胰管空肠Roux-en-Y侧侧吻合术(11例)或胰管空肠侧侧吻合、空肠空肠侧侧吻合术(3例)或胰十二指肠切除术(Child法2例),均将结石取出;内镜治疗胰管结石19例,结石均在3枚或3枚以下、局限在胰头或胰体部、直径小于1cm,取石网篮和气囊取出结石11例,放置胰管支架8例。全组无死亡病例,治疗后3周内症状都不同程度地得到缓解,随诊28例,随诊率为80%,随诊时间为1～43个月。结论胰管结石一旦诊断,均应给予积极的治疗。首选内镜治疗,内镜治疗有着严格的适应证;不适合内镜治疗并且无手术禁忌证的患者均应采取手术治疗。     

Intraoperative sonography of hepatocellular carcinoma: detection of lesions and validity in surgical resection.

Eighty-six hepatocellular carcinomas (HCCs) in 67 patients were examined by intraoperative sonography. Sensitivity for detecting tumors with intraoperative sonography was compared with sonography, computed tomography (CT), hepatic angiography, and CT after intraarterial injection of iodized poppy-seed oil (Lipiodol-CT). The overall sensitivities were 76% with sonography, 86% with CT, 89% with angiography, 96% with Lipiodol-CT, and 98% with intraoperative sonography. The differences in sensitivity between intraoperative sonography and sonography (p less than 0.01), CT (p less than 0.01), and angiography (p less than 0.05) were significant. In 35 lesions smaller than 2 cm, the sensitivities of Lipiodol-CT and intraoperative sonography were high (91 and 94%, respectively). In operating field, tumors were invisible in 36 (42%) and nonpalpable in 31 of 86 cases (36%). In 35 tumors smaller than 2 cm, invisible tumors were 66% and nonpalpable tumors were 63%. However, 84 of 86 cases (98%) could be localized with intraoperative sonography. These results suggest that intraoperative sonography is the final diagnostic imaging procedure before surgical resection of tumors and in cases of invisible and nonpalpable tumors in the operating field, this procedure is mandatory to improve surgical results.     

消化内镜日间手术适宜术式探索：1年850例次患者的经验分享

目的探讨消化内镜日间病房模式和日间手术适宜术式。 方法前瞻性收集2016年10月至2017年10月经解放军总医院第一医学中心消化科日间病房收治850例次患者的临床资料,分析其手术成功率、并发症发生率、转科率、住院总费用及药费比等指标。 结果850例次收治中,开展日间手术812例,手术成功率99.88%(811/812)。出血、穿孔等并发症5例,其发生率0.62%(5/812),均内镜下成功处理,无1例转送外科手术。由于潜在出血风险,5例术后转入普通消化病房,转科率为0.59%(5/850)。消化内镜日间手术前5位的有：结直肠息肉切除术(525例)、胃息肉切除术(112例)、消化道狭窄内镜下治疗术(球囊/探条扩张/瘢痕松解术,86例)、胃食管早癌射频消融术(14例)、EUS/FNA和食管平滑肌瘤及乳头状瘤切除术(各12例)。 结论消化内镜日间开展胃肠息肉切除术、消化道狭窄内镜下治疗术、胃食管早癌射频消融术及EUS/FNA等手术,是安全、可行的。该消化内镜日间病房模式及开展术式,可为其他中心日间病房的开展与运行提供参考。     

Comparison of endoscopic ultrasound and magnetic resonance imaging in severe pelvic endometriosis

Deep pelvic endometriosis may lead to severe pain, the treatment of which may require complete surgical resection of lesions. Digestive infiltration is a difficult therapeutic problem. Preoperative diagnosis is difficult and digestive infiltration may remain unknown with incomplete resection and sometimes repeated surgery. Both magnetic resonance imaging (MRI) and endoscopic ultrasonography are able to detect rectosigmoid infiltration but their usefulness in the preoperative staging is still to be evaluated. The aim of this work was to evaluate and compare both techniques in the preoperative detection of deep pelvic endometriosis, particularly digestive infiltration. PATIENTS AND METHODS: From 1996 to 1998, 48 women with painful deep pelvic endometriosis had preoperative imaging exploration with endoscopic ultrasonography and MRI, and were operated on in order to attempt complete endometriosis resection. Patients were proposed for laparoscopic resection if endoscopic ultrasonography and/or MRI did not reveal digestive infiltration or for open resection if endoscopic ultrasonography and/or MRI were positive for digestive infiltration. RESULTS: Endoscopic ultrasonography and/or MRI led to suspicion of digestive endometriosis in 16 patients. Surgical resection was performed in 12 and digestive wall invasion was histologically demonstrated. At final follow-up, all patients had a dramatic decrease of their symptoms. The remaining 4 patients refused digestive resection and had only laparoscopic gynecologic resection. Infiltration although not histologically proven was very likely both on operative findings and clinical evolution. Digestive infiltration was preoperatively excluded in the 32 other patients. All had a laparoscopic treatment without digestive resection and pain diminished in all patients. In the 12 patients group who had digestive resection, digestive infiltration was correctly diagnosed by endoscopic ultrasonography in all cases (no false negative) whereas MRI, even with the use of endocoil antenna, led to correct diagnosis in 8 out of 12 cases. When endoscopic ultrasonography was negative for digestive infiltration, laparoscopic resection of lesions at surgery appeared complete in all cases. For the 16 patients with presumed digestive infiltration, sensitivity of endoscopic ultrasonography and MRI was 100 and 75% respectively, with a 100% specificity in both cases. MRI appeared very accurate for the detection of ovarian endometriotic locations. MRI was more sensitive but less specific than endoscopic ultrasonography for the diagnosis of isolated endometriotic recto-vaginal septum and utero-sacral ligaments lesions. CONCLUSION: Endoscopic ultrasonography was the best technique for the diagnosis of digestive endometriotic infiltration, which complicates the therapeutic strategy. MRI, however, allows more complete staging of other pelvic endometriotic lesions.     

Endoscopic findings in a biennial follow-up program in patients with pernicious anemia

BACKGROUND/AIMS: It is known that patients with pernicious anemia have a higher risk of gastric neoplasms. However, the optimal endoscopic follow-up in these patients has not been properly defined. This study was aimed to assess the usefulness of an endoscopic follow-up program. METHODOLOGY: We analyzed the endoscopic and histological findings of the first endoscopy performed in a group of 128 patients with the diagnosis of pernicious anemia who were referred to the Endoscopic Unit, and we evaluated the results of the biannual follow-up endoscopies made to 68 of them. RESULTS: The initial endoscopy did not provide evidence of any lesions in 107 patients (83.5%), and polypoid lesions were found in 12 cases (9.4%). The histological results showed gastric dysplasia in 3 patients (2.3%) and carcinoid tumor in 2 cases (1.6%). No cases of gastric carcinoma were found. During the endoscopic follow-up of 68 patients, in 52 of them (76.8%) there were no endoscopic findings, and raised lesions were detected in 8 patients (11.8%). Three cases of gastric dysplasia were found. No cases of gastric carcinoma or carcinoid were detected during the follow-up. CONCLUSIONS: We suggest that a biannual endoscopic follow-up in not useful for the early detection of gastric neoplasms in patients with pernicious anemia.