双气囊内镜检查和小肠CT扫描对早期小肠间质瘤的诊断价值

目的 探讨双气囊内镜(DBE)检查和小肠计算机断层摄像(CT)扫描在小肠间质瘤早期诊断中的应用价值.方法 收集经术后病理学检查明确诊断为小肠间质瘤的患者资料,定义肿瘤直径＜5 cm为早期病变.筛选具有DBE检查或小肠CT扫描完整记录的61例早期肠间质瘤患者的临床和随访资料.回顾性分析相关前期检查(包括胃镜、肠镜、腹部B超、血管造影和胶囊内镜等)、DBE检查、小肠CT扫描及DBE与小肠CT联合检查的病变阳性提示获得或病变检出情况,以及随访期间肿瘤复发和患者生存情况.结果 在小肠CT扫描和DBE检查前,61例患者接受相关前期检查后44例(72.13%)获得阳性提示.56例患者接受单纯DBE检查,检出病变52例(92.86%);42例患者接受单纯小肠CT扫描,检出病变37例(88.10%);两者病变检出率比较差异无统计学意义(P＞0.05).25例患者接受DBE与小肠CT扫描联合检查,病变检出率达100%.所有患者均经手术治疗,中位随访期35个月;无病生存59例(96.7%),带瘤生存2例(均为肿瘤复发病例经口服化疗药物治疗).结论 DBE检查和小肠CT扫描对早期小肠间质瘤的诊断价值较高;两者联合应用有助于肿瘤的及早诊断和及时治疗,从而改善患者预后.

Value of double balloon endoscopy and small bowel CT scan in early diagnosis of small intestinal stromal tumors

Objective To explore the value of double balloon endoscopy (DBE) and small bowel computed tomography (CT) scan in the early diagnosis of small intestinal stromal tumors. Methods The data of patients with small intestinal stromal tumors confirmed by postoperative pathology were collected, and tumors with diameter less than 5 cm were defined as early stage small intestinal stromal tumors. The clinical and follow-up data of 61 patients with early stage small intestinal stromal tumors and complete medical records of DBE or small bowel CT scan were screened. The positive findings from gastroscopy, enteroscopy, abdominal B ultrasonography, angiography, capsule endoscopy, DBE, small bowel CT scan and combination examinations of DBE and small bowel CT scan, together with data of tumor recurrence and survival were retrospectively analysed. Results Before small bowel CT scan and DBE examinations, 61 patients underwent  the other examinations, and positive findings were obtained in 44 cases (72.13%). Fifty-six patients received single DBE examinations, with 52 (92.86%) positive findings, and 42 patients underwent single small bowel CT scan, with 37 (88.10%) positive findings. There was no significant difference in the detection rates between patients with single DBE examinations and those with single small bowel CT scan (P>0.05). Twenty-five patients received combination examinations of DBE and small bowel CT scan, and the detection rate was 100%. All patients were performed operations, with 35 months of median time of follow-up. There were 59 cases (96.7%) with disease-free survival and 2 cases with tumor-bearing survival (both of the 2 cases were treated with chemotherapy after tumor recurrence). Conclusion Both small bowel CT scan and DBE have high detection rates for small intestinal stromal tumors, and the combination of these two methods will be helpful for the early diagnosis and favourable prognosis.