Xu Guo-Qiang, Zhang Bing-Ling, Li You-Ming, Chen Li-Hua, Ji Feng, Chen Wei-Xing, Cai Shu-Ping
Department of Gastroenterology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
World J Gastroenterol. 2003 Sep;9(9):2088-91. doi: 10.3748/wjg.v9.i9.2088.
To investigate the clinical pathologic features of gastrointestinal leiomyoma and the diagnostic value of endoscopic ultrasonography (EUS) on gastrointestinal leiomyoma.
A total of 106 patients with gastrointestinal leiomyoma diagnosed with EUS were studied. The location, size and layer origin of gastric and esophageal leiomyomas were analyzed and compared. The histological diagnosis of the resected specimens by endoscopy or surgery in some patients was compared with their results of EUS.
The majority of esophageal leiomyomas were located in the middle and lower part of the esophagus and their size was smaller than 1.0 cm, and 62.1 % of esophageal leiomyomas originated from the muscularis mucosae. Most of the gastric leiomyomas were located in the body and fundus of the stomach with a size of 1-2 cm. Almost all gastric leiomyomas (94.2 %) originated from the muscularis propria. The postoperative histological results of 54 patients treated by endoscopic resection or surgical excision were completely consistent with the preoperative diagnosis of EUS, and the diagnostic specificity of EUS to gastrointestinal leiomyoma was 94.7 %.
The size and layer origin of esophageal leiomyomas are different from that of gastric leiomyomas. Being safe and accurate, EUS is the best method not only for gastrointestinal leiomyoma diagnosis but also for the follow-up of patients.
探讨胃肠道平滑肌瘤的临床病理特征及内镜超声检查（EUS）对胃肠道平滑肌瘤的诊断价值。
对106例经EUS诊断为胃肠道平滑肌瘤的患者进行研究。分析并比较胃和食管平滑肌瘤的位置、大小及起源层次。将部分患者经内镜或手术切除标本的组织学诊断结果与其EUS检查结果进行比较。
大多数食管平滑肌瘤位于食管中下段，大小小于1.0 cm，62.1%的食管平滑肌瘤起源于黏膜肌层。多数胃平滑肌瘤位于胃体和胃底，大小为1 - 2 cm。几乎所有胃平滑肌瘤（94.2%）起源于固有肌层。54例经内镜切除或手术切除治疗的患者术后组织学结果与术前EUS诊断完全一致，EUS对胃肠道平滑肌瘤的诊断特异性为94.7%。
食管平滑肌瘤与胃平滑肌瘤的大小及起源层次不同。EUS安全准确，是胃肠道平滑肌瘤诊断及患者随访的最佳方法。
