文章摘要

超声内镜在消化道早期癌症诊治中的应用及其临床价值

作者: 1曹志荣, 1周彪, 1汤建伟, 1王国英
1 溧阳市人民医院消化科,江苏 溧阳 213300
通讯: 周彪 Email: zhoubiao751023@163.com
DOI: 10.3978/j.issn.2095-6959.2020.12.018

摘要

目的:探究超声内镜(endoscopic ultrasonography,EUS)在早期消化道癌症患者诊治中的临床价值。方法:选择溧阳市人民医院2018年1月至2020年5月收治的消化道早期癌症患者74例,回顾性分析患者的临床资料,根据不同诊治方式分为对照组(34例,白光内镜+色素染色)及MPS组[40例,小探头超声内镜(mini-probe sonography,MPS)]。2组患者均在接受EUS/MPS后1~2周接受内镜黏膜切除术(endoscopic mucosal resection,EMR)或内镜黏膜下层剥离术(endoscopic submucosal dissection,ESD),以最终手术及病理检查结果为金标准,观察两种EUS技术疾病类型诊断符合情况,病变位置、病变直径、组织分化类型方面的诊断准确率情况,评估2组患者接受检查时疼痛情况,统计整个诊治过程中患者出血、穿孔等并发症发生情况。结果:MPS组与对照组对比,2组疾病类型诊断符合率对比无显著差异(P>0.05),病变直径、组织分化类型诊断准确率对比均未见显著差异(P>0.05),MPS组病变位置诊断准确率显著高于对照组(P<0.05),检查时MPS组疼痛发生率显著高于对照组(P<0.05),整个诊治期间患者并发症发生率比较MPS组显著低于对照组(P<0.05)。结论:胃癌、结直肠癌等消化道早期癌症患者诊治中使用EUS具有诊断准确高,并发生症少的优点,且患者耐受更佳,可优先选用。
关键词: 超声内镜;消化道早期癌症;诊治;临床价值;小探头超声内镜

Application and clinical value of endoscopic ultrasonography in the diagnosis and treatment of early gastrointestinal cancer

Authors: 1CAO Zhirong, 1ZHOU Biao, 1TANG Jianwei, 1WANG Guoying
1 Department of Gastroenterology, Liyang People’s Hospital, Liyang Jiangsu 213300, China

CorrespondingAuthor: ZHOU Biao Email: zhoubiao751023@163.com

Abstract

Objective: To explore the clinical value of ultrasonic endoscopy in the diagnosis and treatment of patients with early gastrointestinal cancer. Methods: Select 74 patients with early gastrointestinal cancer admitted in our hospital during 2018.1 to 2020.5, retrospectively analyze the clinical data of these 74 patients, and divide them into a control group (34 cases, white light endoscopy + pigment staining) according to different diagnosis and treatment methods and min-probe sonography (MPS) group (40 cases, small probe ultrasound endoscopy), patients in both groups received endoscopy 1 to 2 weeks after receiving endoscopic ultrasonography (EUS)/MPS endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD), with the final surgery and pathological examination results as the gold standard, observe the two types of ultrasound endoscopic diagnosis of disease compliance, lesions diagnosis accuracy rate in terms of location, lesion diameter, and tissue differentiation type, to assess the pain of the two groups of patients during the examination, and to count the occurrence of complications such as bleeding and perforation during the entire diagnosis and treatment process. Results: Compared with the control group in MPS group, there was no significant difference in the diagnostic coincidence rate between the two groups of disease types (P>0.05). There was no significant difference in the diagnosis accuracy of lesion diameter and tissue differentiation type (P>0.05). The accuracy of location diagnosis was significantly higher than that of the control group (P<0.05). The incidence of pain in the MPS group during the examination was significantly higher than that of the control group (P<0.05). The incidence of complications during the entire diagnosis and treatment period was significantly lower in the MPS group than in the control group (P<0.05). Conclusion: The use of ultrasound endoscopy in the diagnosis and treatment of gastric cancer, colorectal cancer and other gastrointestinal cancer patients has the advantages of high diagnosis accuracy and few occurrences, and the patients are better tolerated and can be preferred.
Keywords: endoscopic ultrasonography; early gastrointestinal cancer; diagnosis and treatment; clinical value; small probe endoscopic ultrasonography