内镜超声检查对食管平滑肌瘤的诊治价值

目的 探讨内镜超声检查(EUS)对食管平滑肌瘤的诊治价值.方法 分析研究经EUS诊断为食管平滑肌瘤患者的临床表现及血清学、常规胃镜、EUS等检查结果.将EUS的诊断结果与内镜或手术切除的组织病理诊断结果进行比较.治疗后随访2～36个月,平均14.3个月,以观察疾病复发情况.结果 EUS诊断食管平滑肌瘤191例.患者的临床表现、血清学检查、常规胃镜和螺旋CT对食管平滑肌瘤无特异性诊断作用.116例分别接受内镜(111例)或外科手术(5例)摘除治疗,101例术后组织病理确诊为食管平滑肌瘤,EUS对该病的诊断准确率为87%.随访75例未治疗者和116例治疗者,发现前者病灶无明显变化,后者术后无复发.结论 食管平滑肌瘤是一种良性肿瘤,EUS对该病的诊治具有较高的临床价值.

The value of endoscopic ultrasonography for management of esophageal leiomyoma

Objective To investigate clinical value of endoscopic ultrasonography (EUS) on diagnosis and treatment of esophageal leiomyoma.Methods The clinical feature of patients diagnosed as esophageal leiomyoma by EUS was analyzed.All patients underwent conventional gastroscopy and EUS examination as well as blood test.The EUS findings were compared with histopatholoical diagnosis for endoscopically or surgically resected specimens.All patients were followed-up with EUS for 14.3 months (range 2-36 months) for leiomyoma recurrence.Results A total of 191 patients were diagnosed with esophageal leiomyomas by EUS.Clinical manifestation,serum examination,conventional gastroscopy and spiral CT were not helpful for diagnosing esophageal leiomyoma,One hundred and sixteen patients with esophageal leiomyomas were treated by either endoscopic resection (111 cases) or surgical excision (5 cases).of which,101 resected specimens were pathologically confirmed as leiomyomas.The diagnostic accuracy of EUS was 87%.The follow-up study showed that there was no change of leiomyomas in 75 untreated patients and no recurrence was found in 116 surgically treated patients.Conclusion Esophageal leiomyoma is a benign tumor,EUS plays a very important role in diagnosis and treatment of this disease.