内镜超声弹性成像对胃黏膜下肿瘤的诊断潜力：一项初步研究。

Diagnostic potential of endoscopic ultrasonography-elastography for gastric submucosal tumors: A pilot study.

作者信息

Tsuji Yuichiro, Kusano Chika, Gotoda Takuji, Itokawa Fumihide, Fukuzawa Masakatsu, Sofuni Atsushi, Matsubayashi Jun, Nagao Toshitaka, Itoi Takao, Moriyasu Fuminori

机构信息

Departments of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.

Anatomic Pathology, Tokyo Medical University, Tokyo, Japan.

出版信息

Dig Endosc. 2016 Mar;28(2):173-8. doi: 10.1111/den.12569. Epub 2015 Dec 10.

DOI:10.1111/den.12569

PMID:26530730

Abstract

BACKGROUND AND AIM

Qualitative diagnosis for gastric submucosal tumors (SMT) is not easy. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in combination with EUS-elastography (EUS-EG) is reported useful for qualitatively diagnosing pancreatic tissues. We prospectively studied whether EUS-EG could be useful in qualitative diagnosis of gastric SMT.

METHODS

We prospectively registered 25 consecutive patients with gastric SMT diagnosed by esophagogastroduodenoscopy and carried out qualitative evaluations using EUS-EG (May 2013 to March 2015) followed by histopathological diagnosis using EUS-FNA or endoscopic mucosal cutting biopsy. Elastic scores of gastric SMT were compared to the cytological diagnosis.

RESULTS

Of 25 patients, 22 had a confirmed cytological diagnosis. Regarding the Giovannini elastic score, of three patients with aberrant pancreas, one was score 1 and two were score 2; of eight patients with leiomyoma, seven were score 2 and one was score 3. Both of two patients with schwannoma were score 4. Of nine patients with gastrointestinal stromal tumor, six were score 4 and three were score 5. Gastrointestinal stromal tumor (GIST) is harder than other types of gastric SMT, and our study's findings suggested the usefulness of EUS-EG, which can also assess tumor hardness of gastric SMT.

CONCLUSION

EUS-EG might be helpful for the differential diagnosis of gastric SMT, especially to differentiate GIST from other SMT.

摘要

背景与目的

胃黏膜下肿瘤（SMT）的定性诊断并不容易。据报道，内镜超声引导下细针穿刺活检（EUS-FNA）联合内镜超声弹性成像（EUS-EG）有助于胰腺组织的定性诊断。我们前瞻性地研究了EUS-EG在胃SMT定性诊断中是否有用。

方法

我们前瞻性地纳入了25例经食管胃十二指肠镜诊断为胃SMT的连续患者，并使用EUS-EG进行定性评估（2013年5月至2015年3月），随后通过EUS-FNA或内镜黏膜切除活检进行组织病理学诊断。将胃SMT的弹性评分与细胞学诊断结果进行比较。

结果

25例患者中，22例有确诊的细胞学诊断。关于乔瓦尼尼弹性评分，3例异位胰腺患者中，1例评分为1分，2例评分为2分；8例平滑肌瘤患者中，7例评分为2分，1例评分为3分。2例施万瘤患者均评分为4分。9例胃肠道间质瘤患者中，6例评分为4分，3例评分为5分。胃肠道间质瘤（GIST）比其他类型的胃SMT更硬，我们的研究结果表明EUS-EG有用，它还可以评估胃SMT的肿瘤硬度。