不明原发灶癌的上消化道内镜和结肠镜检查的检出率。

Yield of esophagogastroduodenoscopy and colonoscopy in cancer of unknown primary.

机构信息

Muhammad Tayyab Usmani, Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, Stadium Road, PO Box # 74800, Karachi, Pakistan.

Abdullah Bin Khalid, Dow University of Health Sciences, Karachi, Pakistan.

出版信息

Pak J Med Sci. 2013 Apr;29(2):523-7. doi: 10.12669/pjms.292.3212.

DOI:10.12669/pjms.292.3212

PMID:24353569

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3809229/

Abstract

OBJECTIVES

Carcinoma of unknown primary origin (CUP) is heterogeneous group of cancers. Role of gastrointestinal (GI) endoscopy in this entity is under investigated. Aim of this study was to evaluate yield of Colonoscopy and Esophagogastroduodenoscopy (EGD) in localizing primary tumor in patients with CUP.

METHODOLOGY

Patients with histopathologically proven CUP who underwent colonoscopy / EGD to find the primary tumor from December 2009 to December 2011 were included in the study. Abdominal symptoms and cytokeratin (CK) 7 and 20 markers were correlated with presence of primary in GI tract.

RESULTS

After giving informed consent 86 patients were included in final analysis. All patients underwent colonoscopy while 60(70%) got EGD along with colonoscopy. Mean age was 55.10 +/-11.94 years with 52(60%) male. Abdominal symptoms were present in 50%. CK7+/CK20- in 34(40%); CK7-/CK20+ in 2(2%) while CK7+/20+ in 7(8%) of metastatic tumor samples. Liver was metastatic site in 47(55%), Lymph node 12(14%) and Ascites in 8(9%). Endoscopy detected primary in 6 (7%) patients with 3 each in stomach and colon. No association of abdominal symptoms and cytokeratin markers was found with presence of GI primary site.

CONCLUSION

Yield of localizing primary lesion in the GI tract by pan-endoscopy was limited. Abdominal symptoms and cytokeratin markers do not predict presence of gastrointestinal malignancies.

摘要

目的

原发灶不明的癌（CUP）是一组异质性的癌症。胃肠内镜在该实体中的作用尚未得到充分研究。本研究的目的是评估结肠镜和食管胃十二指肠镜（EGD）在定位CUP 患者原发性肿瘤中的作用。

方法

纳入 2009 年 12 月至 2011 年 12 月期间接受结肠镜检查/EGD 以寻找原发性肿瘤的经组织病理学证实为 CUP 的患者。将腹部症状和细胞角蛋白（CK）7 和 20 标志物与胃肠道中原发性肿瘤的存在相关联。

结果

在获得知情同意后，86 例患者被纳入最终分析。所有患者均接受了结肠镜检查，而 60 例（70%）患者同时进行了结肠镜检查和 EGD。平均年龄为 55.10 ± 11.94 岁，其中 52 例（60%）为男性。50%的患者存在腹部症状。34 例（40%）转移性肿瘤样本中 CK7+/CK20-；2 例（2%）为 CK7-/CK20+；7 例（8%）为 CK7+/20+。47 例（55%）患者的肝转移，12 例（14%）患者的淋巴结转移，8 例（9%）患者的腹水转移。内镜检查在 6 例患者（7%）中发现了原发性肿瘤，其中胃和结肠各 3 例。腹部症状和细胞角蛋白标志物与胃肠道原发性肿瘤的存在无相关性。