结肠镜检查结果与结直肠子宫内膜异位症的组织学诊断率。
Colonoscopic findings and histologic diagnostic yield of colorectal endometriosis.
机构信息
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
出版信息
J Clin Gastroenterol. 2011 Jul;45(6):536-41. doi: 10.1097/MCG.0b013e3181fd297b.
BACKGROUND
No study has systematically investigated the colonoscopic findings and histologic diagnostic yield in the diagnosis of colorectal endometriosis.
OBJECTIVES
We classified the colonoscopic features of colorectal endometriosis and determined the diagnostic yield of endoscopic biopsy in relation to endoscopic subtypes of colorectal endometriosis.
METHODS
A total of 17 patients with colorectal endometriosis were assessed. The data from the colonoscopic and histologic assessments made between November 1994 and October 2009 were retrospectively analyzed in single tertiary referral teaching hospital.
RESULTS
Colonoscopy showed eccentric wall thickening in 14 patients (82%) and polypoid lesions in 3 patients (18%). Surface nodularities were noted in 11 of the 14 patients (79%) with eccentric wall thickening, and in 1 of the 3 patients (33%) with polypoid lesions. The overall histologic diagnostic yield was 47% (8 of the 17 patients). The rate of histologic confirmation was higher in patients with surface nodularities (8 of the 12 patients, 67%) versus those without (0 of the 5 patients, 0%) surface nodularities (P=0.02).
CONCLUSIONS
Eccentric wall thickening is the most common colonoscopic finding of colorectal endometriosis, and the histologic diagnostic yield of endoscopic biopsy is high when lesions are accompanied by surface nodularities.
背景
目前尚无研究系统地调查过结直肠子宫内膜异位症的结肠镜检查结果和组织学诊断率。
目的
我们对结直肠子宫内膜异位症的结肠镜特征进行了分类，并确定了内镜活检在结直肠子宫内膜异位症内镜亚型中的诊断率。
方法
共评估了 17 例结直肠子宫内膜异位症患者。对 1994 年 11 月至 2009 年 10 月在一家三级转诊教学医院进行的结肠镜和组织学评估的数据进行了回顾性分析。
结果
结肠镜检查显示 14 例患者（82%）存在偏心性壁增厚，3 例患者（18%）存在息肉样病变。在 14 例偏心性壁增厚患者中有 11 例（79%）存在表面结节，在 3 例息肉样病变患者中有 1 例（33%）存在表面结节。总体组织学诊断率为 47%（17 例患者中的 8 例）。有表面结节的患者（12 例中的 8 例，67%）与无表面结节的患者（5 例中的 0 例，0%）相比，组织学确诊率更高（P=0.02）。
结论
偏心性壁增厚是结直肠子宫内膜异位症最常见的结肠镜检查结果，当病变伴有表面结节时，内镜活检的组织学诊断率较高。
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