Varas Lorenzo M J, Armengol Miró J R, Boix Valverde J, Maluenda Colomer M D, Pou Fernández J M
Servicio de Endoscopia, Hospital General de Cataluña, Universidad Autónoma de Barcelona.
Gastroenterol Hepatol. 1999 May;22(5):223-6.
Around 30% of the gastroenteropancreatic endocrine tumors (GPET) cannot be preoperatively identified by the common diagnostic imaging techniques. The aim of this retrospective study was to present our experience in the diagnosis and localization of GPET by endoscopic ultrasonography (EUS) performed prior to surgery and compare this with a review of the literature.
Twenty patients suspected of having specific hormonal syndromes were correlatively explored with US, CT, MR, angiography, octreoscan and radial EUS with Olympus GFUM3/EUM3 and GF-UM20/EUM 20 and 30. Eleven cases were males (55%) and 9 (45%) females with a mean age of 60 years (range: 40-80 years). Of the 20 patients, 14 had endocrine 16 tumors in the pancreas and 6 tumors in the gastrointestinal tract. In 6 patients no tumors were found and were therefore used as a control group. Of the 20 patients, 14 underwent surgery confirming the existence of GPET in 12 cases.
The diagnostic sensitivity and precision of the EUS were of 75 and 78%, respectively, with these percentages being higher to those obtained with other imaging techniques. The specificity was 83%. All these values were slightly lower than the mean obtained on review of the literature. Two pancreatic tumors of less than or equal to 1 cm were detected which had not been previously diagnosed with US, CT and MR. In two cases the exact situation was not determined. Echo-endoscopic exploration of the pancrease could not be completely performed in two cases (10%), one pancreatic carcinoma and one double pancreatic gastrinoma which was gastrectomized. Endoscopic ultrasonography is a good preoperative technique for detecting GPET and in the evaluation of small sized tumors it may surpass other imaging techniques. The usefulness of EUS as a second exploration following US has been suggested for the diagnosis and localization prior to surgery.
约30%的胃肠胰内分泌肿瘤（GPET）无法通过常规诊断成像技术在术前识别。这项回顾性研究的目的是介绍我们在术前通过内镜超声检查（EUS）诊断和定位GPET的经验，并与文献综述进行比较。
对20例疑似患有特定激素综合征的患者进行了超声（US）、计算机断层扫描（CT）、磁共振成像（MR）、血管造影、奥曲肽扫描以及使用奥林巴斯GFUM3/EUM3和GF-UM20/EUM 20及30进行的径向EUS相关检查。11例为男性（55%），9例为女性（45%），平均年龄60岁（范围：40 - 80岁）。20例患者中，14例胰腺有内分泌肿瘤，16个肿瘤，胃肠道有6个肿瘤。6例患者未发现肿瘤，因此用作对照组。20例患者中，14例接受了手术，12例术中证实存在GPET。
EUS的诊断敏感性和准确性分别为75%和78%，这些百分比高于其他成像技术。特异性为83%。所有这些值略低于文献综述得出的平均值。检测到2例直径小于或等于1 cm的胰腺肿瘤，此前US、CT和MR未诊断出。2例情况未明确。2例（10%）无法完全进行胰腺的超声内镜检查，1例为胰腺癌，1例为已行胃切除术的双胰腺胃泌素瘤。内镜超声检查是检测GPET的良好术前技术，在评估小尺寸肿瘤方面可能优于其他成像技术。有人建议将EUS作为US之后的二次检查用于术前诊断和定位。
