Limitations of endoscopic ultrasonography in diagnosis of gastric submucosal tumors
10.3969/j.issn.1007-1989.2018.01.006
- VernacularTitle:超声内镜在胃黏膜下肿瘤诊断中的局限性
- Author:
Lan-Ping ZHU
1
;
Ze-Gui WANG
;
Shuang MA
;
Bian-Xia LI
;
Yang-Yang HUI
;
Xue-Yan ZHOU
;
Xin CHEN
;
Bang-Mao WANG
Author Information
1. 天津医科大学总医院 消化内科
- Keywords:
gastric submucosal tumors;
endoscopic ultrasonography;
diagnostic coincidence;
limitations
- From:
China Journal of Endoscopy
2018;24(1):29-33
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate endoscopic ultrasonography (EUS) in diagnosis of gastric submucosal tumors (SMTs), and analyze the characteristics of gastric SMTs under EUS. Methods Clinical data of 614 patients with gastric SMTs, who were evaluated by EUS and underwent endoscopic submucosal dissection (ESD) from September 2008 to December 2016, were retrospectively analyzed. The golden standard for lession origins was the intraoperative diagnosis of ESD, and that for pathological types was the combination of postoperative pathological and immunohistochemical findings. The consistency of diagnosis of EUS was evaluated, and the characteristics of lesions under EUS were analyzed. Results The total consistency in diagnosing lesion origins was 91.25％ between EUS and intraoperative results of ESD, and the consistency in diagnosing lesion originated from the muscularis mucosa, submucosa and muscularis propria was 66.67％, 80.85％ and 94.50％, respectively. The total consistency in pathological types was 65.99％ between EUS and postoperative pathological results, and the consistency of gastrointestinal stromal tumor (GIST), leiomyoma, ectopic pancreas and lipoma was 91.85％, 18.56％, 79.76％ and 90.70％, respectively. Conclusion EUS can initially determine the origins and types of gastric SMTs, providing a more accurate basis for endoscopic treatment, but there were some limitations on the diagnosis of leiomyoma and some rare lesions such as hamartoma, inflammatory fibrous polyps, carcinoid, fibroma, etc. Thus, if necessary, the lesion should be removed so as to make a definite diagnosis and prevent malignant change.
