超声内镜检查对消化道黏膜下病变的诊断价值
|
摘要
目的:探讨超声内镜检查对消化道黏膜下病变的诊断价值。方法:回顾性分析62例疑似消化道黏膜下病变体检者的临床资料,将超声内镜检查结果与病理学检查结果对照,分析消化道黏膜下病变的超声内镜的特征。结果:超声内镜检查对消化道黏膜下病变的敏感度、特异度、阳性预测值、阴性预测值、准确度分别为100%、25.00%、95.08%、100%、95.16%,超声内镜检查与病理学检查对消化道黏膜下病变的诊断水平比较,差异无统计学意义(P>0.05);不同类型的消化道黏膜下病变有不同表现的超声内镜特征。结论:超声内镜检查对鉴别消化道黏膜下病变的性质及制定治疗方案具有指导意义。
Objective:To explore the diagnostic value of endoscopic ultrasonography in submucosal lesions of digestive tract.Method:The clinical data of 62 suspected submucosal lesions of digestive tract patients were analyzed retrospectively.The results of endoscopic ultrasonography were compared with pathological examination,and the characteristics of endoscopic ultrasonography in submucosal lesions of digestive tract were analyzed.Result:The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of endoscopic ultrasonography for submucosal lesions of digestive tract were 100%,25.00%,95.08%,100%,95.16% respectively,the diagnostic level of endoscopic ultrasonography and pathological examination for submucosal lesions of digestive tract was compared,the difference was not statistically significant(P>0.05).Different types of submucosal lesions of digestive tract had different characteristics of endoscopic ultrasonography.Conclusion:Endoscopic ultrasonography is of guiding significance in identifying the nature of submucosal lesions of digestive tract and in formulating treatment regimens.
Objective:To explore the diagnostic value of endoscopic ultrasonography in submucosal lesions of digestive tract.Method:The clinical data of 62 suspected submucosal lesions of digestive tract patients were analyzed retrospectively.The results of endoscopic ultrasonography were compared with pathological examination,and the characteristics of endoscopic ultrasonography in submucosal lesions of digestive tract were analyzed.Result:The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of endoscopic ultrasonography for submucosal lesions of digestive tract were 100%,25.00%,95.08%,100%,95.16% respectively,the diagnostic level of endoscopic ultrasonography and pathological examination for submucosal lesions of digestive tract was compared,the difference was not statistically significant(P>0.05).Different types of submucosal lesions of digestive tract had different characteristics of endoscopic ultrasonography.Conclusion:Endoscopic ultrasonography is of guiding significance in identifying the nature of submucosal lesions of digestive tract and in formulating treatment regimens.
引文
[1]邓薇,陈道荣.上消化道黏膜下肿物病理诊断流行病学研究[J].现代医药卫生,2016,32(6):827-830.
[2]梁丽,张继新,戎龙,等.80例早期胃癌及癌前病变内镜黏膜下剥离术标本的处理及病理学评估[J].中华消化内镜杂志,2016,33(9):589-597.
[3]韩渭丽,汤萨,姬玲粉,等.1058例食管良性肿瘤临床病理特征[J].中国肿瘤临床,2016,43(10):424-428.
[4]齐志鹏,钟芸诗,周平红,等.上消化道不同部位黏膜下肿瘤的临床病理学特征[J].中华消化内镜杂志,2016,33(6):362.
[5]王珊珊,沈磊.内镜黏膜下剥离术治疗贲门部病变的进展[J].中华消化内镜杂志,2016,33(1):60-62.
[6]黄强,刘臣海,彭斌,等.超声内镜引导下细针穿刺活检(EUS-FNA)在胰腺占位性病变中的诊断价值及安全性评估[J].肝胆外科杂志,2016,24(3):175-178.
[7]Koo D H,Ryu M H,Kim K M,et al.Asian Consensus Guidelines for the Diagnosis and Management of Gastrointestinal Stromal Tumor[J].Cancer Res Treat,2016,48(4):1155-1166.
[8]朱秀琴,胡兰.内镜超声引导下细针抽吸活检术在上消化道壁外占位病变中的应用及护理[J].全科护理,2017,15(15):1861-1862.
[9]Sotoudehmanesh R,Nejati N,Farsinejad M,et al.Efficacy of Endoscopic Ultrasonography in Evaluation of Undetermined Etiology of Common Bile Duct Dilatation on Abdominal Ultrasonography[J].Middle East J Dig Dis,2016,8(4):267-272.
[10]中华医学会消化内镜学分会外科学组,中国医师协会内镜医师分会消化内镜专业委员会,中华医学会外科学分会胃肠外科学组.中国消化道黏膜下肿瘤内镜诊治专家共识(2018版)[J].中华消化外科杂志,2018,17(8):767-778.
[11]赵恩昊,李晓波,曹晖.2015年日本消化器内视镜学会《早期胃癌内镜黏膜切除术和黏膜下剥离术治疗指南》解读[J].中国实用外科杂志,2016,36(1):79-83.
[12]梁金春,周春贤.内镜窄带成像技术对早期胃癌及癌前病变的诊断价值[J].临床医学工程,2017,24(10):1337-1338.
[13]闪明海,胡爱丽,何芳,等.窄带成像技术普通内镜对结直肠息肉病变性质的预测价值[J].宁夏医科大学学报,2016,38(5):551-553.
[14]滕晓琨,缪林.内镜窄带成像技术在早期胃癌及癌前病变中的诊断价值[J].中国临床研究,2016,29(12):1682-1684.
[15]周鋆,项平,季大年,等.电子结肠镜检查老年大肠息肉患者的漏诊率分析[J].老年医学与保健,2016,22(5):274-276.
[16]Raddaoui E,Almadi M A,Aljebreen A M,et al.Cytologic diagnosis of gastric submucosal lesions by endoscopic ultrasoundguided fine-needle aspiration:A single center experience in Saudi Arabia[J].Indian J Pathol Microbiol,2015,58(4):448-452.
[17]杨英,陈炳芳,丁炎波,等.内镜超声联合CT对纵隔镜下食管癌根治性切除术的临床价值[J].胃肠病学,2016,21(5):296-298.
[18]吴琼,施敏,惠萍萍,等.超声内镜联合螺旋CT检查对胃癌治疗前TNM分期的临床价值[J].临床消化病杂志,2016,28(1):1-4.
[19]Kim B R,Lee J M,Lee D H,et al.Diagnostic Performance of Gadoxetic Acid-enhanced Liver MR Imaging versus Multidetector CT in the Detection of Dysplastic Nodules and Early Hepatocellular Carcinoma[J].Radiology,2017,285(1):134-146.
[20]Aoki M,Hirose K,Sato M,et al.Prognostic impact of average iodine density assessed by dual-energy spectral imaging for predicting lung tumor recurrence after stereotactic body radiotherapy[J].J Radiat Res,2016,57(4):381-386.
[2]梁丽,张继新,戎龙,等.80例早期胃癌及癌前病变内镜黏膜下剥离术标本的处理及病理学评估[J].中华消化内镜杂志,2016,33(9):589-597.
[3]韩渭丽,汤萨,姬玲粉,等.1058例食管良性肿瘤临床病理特征[J].中国肿瘤临床,2016,43(10):424-428.
[4]齐志鹏,钟芸诗,周平红,等.上消化道不同部位黏膜下肿瘤的临床病理学特征[J].中华消化内镜杂志,2016,33(6):362.
[5]王珊珊,沈磊.内镜黏膜下剥离术治疗贲门部病变的进展[J].中华消化内镜杂志,2016,33(1):60-62.
[6]黄强,刘臣海,彭斌,等.超声内镜引导下细针穿刺活检(EUS-FNA)在胰腺占位性病变中的诊断价值及安全性评估[J].肝胆外科杂志,2016,24(3):175-178.
[7]Koo D H,Ryu M H,Kim K M,et al.Asian Consensus Guidelines for the Diagnosis and Management of Gastrointestinal Stromal Tumor[J].Cancer Res Treat,2016,48(4):1155-1166.
[8]朱秀琴,胡兰.内镜超声引导下细针抽吸活检术在上消化道壁外占位病变中的应用及护理[J].全科护理,2017,15(15):1861-1862.
[9]Sotoudehmanesh R,Nejati N,Farsinejad M,et al.Efficacy of Endoscopic Ultrasonography in Evaluation of Undetermined Etiology of Common Bile Duct Dilatation on Abdominal Ultrasonography[J].Middle East J Dig Dis,2016,8(4):267-272.
[10]中华医学会消化内镜学分会外科学组,中国医师协会内镜医师分会消化内镜专业委员会,中华医学会外科学分会胃肠外科学组.中国消化道黏膜下肿瘤内镜诊治专家共识(2018版)[J].中华消化外科杂志,2018,17(8):767-778.
[11]赵恩昊,李晓波,曹晖.2015年日本消化器内视镜学会《早期胃癌内镜黏膜切除术和黏膜下剥离术治疗指南》解读[J].中国实用外科杂志,2016,36(1):79-83.
[12]梁金春,周春贤.内镜窄带成像技术对早期胃癌及癌前病变的诊断价值[J].临床医学工程,2017,24(10):1337-1338.
[13]闪明海,胡爱丽,何芳,等.窄带成像技术普通内镜对结直肠息肉病变性质的预测价值[J].宁夏医科大学学报,2016,38(5):551-553.
[14]滕晓琨,缪林.内镜窄带成像技术在早期胃癌及癌前病变中的诊断价值[J].中国临床研究,2016,29(12):1682-1684.
[15]周鋆,项平,季大年,等.电子结肠镜检查老年大肠息肉患者的漏诊率分析[J].老年医学与保健,2016,22(5):274-276.
[16]Raddaoui E,Almadi M A,Aljebreen A M,et al.Cytologic diagnosis of gastric submucosal lesions by endoscopic ultrasoundguided fine-needle aspiration:A single center experience in Saudi Arabia[J].Indian J Pathol Microbiol,2015,58(4):448-452.
[17]杨英,陈炳芳,丁炎波,等.内镜超声联合CT对纵隔镜下食管癌根治性切除术的临床价值[J].胃肠病学,2016,21(5):296-298.
[18]吴琼,施敏,惠萍萍,等.超声内镜联合螺旋CT检查对胃癌治疗前TNM分期的临床价值[J].临床消化病杂志,2016,28(1):1-4.
[19]Kim B R,Lee J M,Lee D H,et al.Diagnostic Performance of Gadoxetic Acid-enhanced Liver MR Imaging versus Multidetector CT in the Detection of Dysplastic Nodules and Early Hepatocellular Carcinoma[J].Radiology,2017,285(1):134-146.
[20]Aoki M,Hirose K,Sato M,et al.Prognostic impact of average iodine density assessed by dual-energy spectral imaging for predicting lung tumor recurrence after stereotactic body radiotherapy[J].J Radiat Res,2016,57(4):381-386.