超声内镜诊断上消化道黏膜下病变临床价值分析

目的探讨超声内镜(EUS)诊断上消化道黏膜下病变的临床价值.方法回顾分析行超声内镜(EUS)检查的258例上消化道胃黏膜下病变患者临床资料,上述患者行手术或微创手术(ESD等)切除,均有术后病理资料,以术后病理学检查为金标准,通过计算并比较EUS对不同病理类型和病变起源的上消化道黏膜下病变诊断的灵敏度与特异度,对EUS诊断上消化道黏膜下病变的临床价值进行评价分析.结果 EUS对不同病理类型诊断的灵敏度:脂肪瘤平滑肌瘤异位胰腺间质瘤,平均灵敏度为90.97%,组间比较差异无统计学意义(P0.05),特异度:脂肪瘤异位胰腺间质瘤平滑肌瘤,平均特异度96.17%,组间比较差异无统计学意义(P0.05);EUS对不同起源层次的上消化道黏膜下病变诊断灵敏度以固有肌层最高(91.18%),与固有肌层比较,黏膜下层特异度最低(79.41%),差异具有统计学意义(P0.05),平均灵敏度为85.55%,平均特异度为93.27%,各组间特异度比较差异无统计学意义(P0.05).结论 EUS对上消化道黏膜下病变有较高的诊断价值,可为临床诊治上消化道黏膜下病变提供有力证据.

Analysis on the Clinical Value of Endoscopic Ultrasonography in the Diagnosis of Upper Gastrointestinal Mucosa Lesions

Objective To investigate the clinical value of Endoscopic ultrasonography( EUS) in the diagnosis of upper gastrointestinal mucosa lesions. Method The clinical data of 258 cases with upper gastrointestinal mucosa lesions,who had underwent surgery or minimally invasive surgery ( ESD ) , were analyzed retrospectively. The clinical value of endoscopic ultrasonography in the diagnosis of upper gastrointestinal mucosa lesions was analyzed, by calculating and comparing the sensitivity and specificity of endoscopic ultrasonography in the diagnosis of the disease with different pathological types and pathological origin using postoperative pathological examination result as the gold standard. Results The sensitivity sequence of EUS was as follows:lipoma >leiomyoma >heterotopic pancreas >mesenchymoma. The average sensitivity was 90. 97％, and there were no statistically significant difference between the groups ( P>0 . 05 ) . The specificity sequence of EUS was as follows:heterotopic lipoma >pancreas>mesenchymoma >leiomyoma. The average specificity was 96. 17％,and there were no statistically significant difference between the groups (P>0. 05). Compared with the other two groups,the diagnostic sensitivity of EUS for muscularis propria was the highest(91. 18％),the sensitivity for submucous layer was the lowest ( 79 . 41％) , and the difference between the groups was statistically significant ( P<0 . 05 ) . The average sensitivity was 85 . 55％, and the average specificity was 93 . 27％ with no statistically significant difference among the three group. Conclusion EUS has a high value in the diagnosis of upper gastrointestinal mucosa lesions, which can provide powerful evidence for the clinical diagnosis and treatment of upper gastrointestinal submucosal lesions. It is value of clinic application.