论文部分内容阅读
目的探讨高频超声内镜鉴别上消化道黏膜内癌及黏膜下癌的价值。方法129例上消化道早期癌患者术前行高频超声内镜检查,分析上皮内癌、黏膜肌层癌、黏膜下癌的超声影像学特征。34例行内镜下黏膜切除术,5例行内镜下黏膜下剥离术,90例行外科手术。术后标本行病理学检查确定其浸润深度。结果高频超声内镜显示上皮内癌30例,黏膜上皮层增厚,黏膜肌层形态规则;黏膜肌层癌42例,36例黏膜层及黏膜肌层增厚,两层界限不清楚,黏膜下层形态规则,6例黏膜层及黏膜肌层增厚,黏膜下层部分稍增厚,形态规则;黏膜下癌57例,黏膜下层形态改变,变细8例,增粗6例,扭曲5例,不规则10例,部分中断12例,与黏膜肌层分界不清楚16例,固有肌层形态规则。术后病理:黏膜内癌78例,黏膜下癌51例。高频超声内镜判断黏膜内癌特异性为92.2%(47/51),敏感性为87.2%(68/78),黏膜下癌特异性为87.2%(68/78),敏感性为92.2%(47/51),其鉴别黏膜内癌及黏膜下癌准确性为89.1%(115/129)。结论高频超声内镜能较准确鉴别上消化道黏膜内癌及黏膜下癌。
Objective To investigate the value of high-frequency endoscopic ultrasonography in differentiating upper mucosal carcinoma from submucosal carcinoma. Methods 129 cases of early upper gastrointestinal cancer patients underwent high-frequency ultrasound endoscopy before surgery to analyze the intraepithelial neoplasia, mucosal muscular carcinoma, submucosal ultrasound imaging features. 34 cases of endoscopic mucosal resection, 5 cases of endoscopic submucosal dissection, 90 cases of surgical operation. Postoperative pathological examination to determine the depth of invasion. Results High-frequency endoscopic ultrasonography showed intraepithelial neoplasia in 30 cases, with mucosal epithelial thickening and mucosal muscular layer morphology. In 42 cases of mucosal muscular carcinoma, mucosal and mucosal muscular layers were thickened in 36 cases with unclear boundaries and mucosa Under the rules of the lower layer, the thickening of the mucosa and mucosa in 6 cases was thick and the submucosa was thicker and the morphology was regular. Submucosal carcinoma was found in 57 cases. The submucosal morphology was changed and thinned in 8 cases, Irregular in 10 cases, partial interruption in 12 cases, mucosal muscular interdendration is not clear in 16 cases, the inherent muscularis rules. Postoperative pathology: mucosal carcinoma in 78 cases, submucosal carcinoma in 51 cases. The specificity of mucosal carcinoma was 92.2% (47/51), the sensitivity was 87.2% (68/78), the specificity of submucosal carcinoma was 87.2% (68/78) and the sensitivity was 92.2% (47/51). The accuracy of distinguishing intramucosal carcinoma and submucosal carcinoma was 89.1% (115/129). Conclusion High-frequency endoscopic ultrasonography can accurately identify the upper gastrointestinal mucosal carcinoma and submucosal carcinoma.