超声内镜对上消化道占位性病变诊断价值

目的探讨超声内镜(endoscopic ultrasonography,EUS)对上消化道占位性病变诊断的价值。方法以122例在电子胃镜及电子线阵式超声内镜检查后接受内镜下黏膜切除术(endoscopic mucosal resection,EMR)或内镜下黏膜剥离术(endoscopic mucosal dissection,ESD)或外科手术(后统称为手术)的上消化道占位性病变的患者为研究对象,其中33例患者行细针穿刺抽吸细胞学检查(fine-needle aspiration,FNA)。将电子胃镜与EUS检查结果与术后病理诊断进行比较。结果 122例EUS(部分结合FNA)与术后病理的符合率为91.8%(112/122),33例EUS-FNA与术后病理的符合率为96.9%(32/33),电子胃镜检查与术后病理的符合率为77.2%(71/92)。与电子内镜诊断符合率相比,EUS有明显优势。结论 EUS能满意的对上消化道占位性病变进行初步定性诊断,结合FNA检查能有效提高诊断的准确性。

Value of endoscopic ultrasonography in space-occupying lesions of upper gastrointestinal tract

Objective To discuss the value of endoscopic ultrasonography（EUS）in diagnosis of the space-occupying lesions of upper gastrointestinal tract.Methods A total of 122 patients with occupying lesions were examined by electronic gastroscopy and electronic linear scanning endoscopic ultrasonography.All patients received endoscopic mucosal resection（EMR）or endoscopic mucosal dissection（ESD）or surgery.We used fine-needle aspiration（FNA）in 33 cases.The electronic gastroscope and EUS examination results were compared with the pathology results of EUS-FNA with EMR,ESD and surgery.Results 122 cases of EUS（part＋FNA）results met with 91.8%（112/122）of the pathological results;33 cases of EUS-FNA met with 96.9%（32/33）.Electronic gastroscopy and postoperative pathological coincidence rate was 77.2%（71/92）.Compared with the coincidence rate by electronic endoscope diagnosis,EUS had obvious advantages.Conclusion For space-occupying lesions of upper gastrointestinal tract,EUS is a satisfactory preliminary qualitative technique,especially EUS combined with FNA cytology can improve the diagnostic accuracy.