吴正祥 1张明黎 1王佐 1张开光 1丁西平 1卫梅枝 1王巧民1
作者信息
- 1. 安徽医科大学附属省立医院、安徽省立医院消化内科,合肥,230001
- 折叠
摘要
Abstract
Objective To explore the endoscopic ultrasound( EUS)and epidemiological evaluation of the upper gastrointestinal tract lesions.Methods 3032 cases of upper gastrointestinal endoscopic ultrasonography were collected and analyzed, and epidemiological method was used to forward-lookingly assess EUS in cancer staging, pathological source,cystic substantive lesion and the diagnosis of benign and malignant ulcers.Results 1419 cases had protuberant lesions( 1019.of them in gastrointestinal tract wall ), 664 cases with advanced cancer, 11 cases with early cancer,96 cases with ulcer disease, 142 cases with polyps and the other 700 cases.Among 1019 protuberant lesions in tract wall,hypoechoic type is the most common (588/1019,57.7％), which included leiomyoma 414/414, stromal tumor 128/133, lymphoma 7/7, carcinoid 2/2 and submucosal surface cancer 26/28, and anechoic type including cystic lesion( 80/82 cysts, hemangioma 60/66, Brunner gland hyperplasia 33/36 ) and hyperechoic type ( lipoma 52/54 )are generally benign lesions.Among them, there were 716 cases confirmed by pathology or by two different examiners.The sensitivity of endoscopic ultrasonography was 96.6％ ,the specificity was 95.1％ and the agreement rate was 95.9％ in the diagnosis of the lesion source level ,and the discrimination sensitivity between cystic and substantive lesions was 98.7％ ,the specificity was 90.9％ and the agreement rate was 97.9％.There were 32 cases of ulcer disease difficult to identify whether benign or malignant by endoscopic method, and according to echo and the infiltration,the sensitivity of benign or malignant determination was 82.3％ ,the specificity was 80.0％ and theagreement rate was 81.3％.There were 376 cases of upper digestive tract cancer,including 266 esophageal cancer,28 cardiac cancer and 82 gastric cancer cases.The sensitivity of endoscopic ultrasonography in judging tumor invasion depth was85.5％ ,the specificity was 86.4％ ,the agreement rate was 85.9％ ,and the sensitivity in diagnosing local lymph node metastasis was 78.3％ ,the specificity was 80.2％ and the agreement rate was 79.3％.Conclusions EUS has a high diagnostic value for the upper gastrointestinal tract lesions, but it has limitations as an imaging diagnostic method, especially for qualitative diagnosis.关键词
腔内超声检查/胃肠疾病/上胃肠道Key words
Endosonography/ Gastrointestinal diseases/ Upper gastrointestinal tract分类
医药卫生
