Evaluation of miniprobe endoscopic ultrasonography for the diagnosis and treatment of rectal neuroendocrine neoplasms of different origin
10.3760/cma.j.cn321463-20211215-00671
- VernacularTitle:小探头超声内镜在不同起源层次直肠神经内分泌肿瘤诊断与治疗中的价值
- Author:
Weizhen ZHOU
1
;
Guang LI
;
Ru GAO
;
Xiao LIU
;
Yingxin GAO
;
Jianyu HAO
;
Xinjuan LIU
Author Information
1. 首都医科大学附属北京朝阳医院消化内科，北京100020
- Keywords:
Neuroendocrine tumors;
Endosonography;
Rectum
- From:
Chinese Journal of Digestive Endoscopy
2022;39(6):479-483
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the characteristics of endoscopic ultrasonography for rectal neuroendocrine neoplasms (R-NENs) of different origin and its influence on the diagnosis and treatment.Methods:A retrospective cross-sectional study was conducted to analyze 56 cases of R-NENs diagnosed by miniprobe endoscopic ultrasonography (MEUS) and/or pathology in the Endoscopy Center of Beijing Chaoyang Hospital, Capital Medical University from January 2016 to July 2021. The endoscopic ultrasonography characteristics, pathological features, surgical selection and the follow-up of R-NENs originating from deep mucosa and submucosa were compared.Results:Among the 56 patients, 49 were diagnosed as R-NENs.The diagnostic sensitivity, positive predictive value and diagnostic accuracy of MEUS for R-NENs were 93.88% (46/49), 86.79% (46/53) and 82.14% (46/56), respectively. R-NENs were mainly manifested by medium hypoechoic with MEUS [95.92% (47/49)]. Three R-NENs originated from submucosa were missed diagnosis, with 1 case presenting hypoechoic and 2 cases presenting hyperechoic. There were no significant differences in the tumor diameter, echo intensity under endoscopic ultrasonography, echo uniformity and pathological grade composition between deep mucosal origin and submucosal origin R-NENS (all P>0.05), but there was significant differences in the distance from tumor to anus ( χ2=5.011, P=0.025). The proportion of the distance from tumor to anus ≤5 cm of submucosal origin lesions was significantly higher than that of deep mucosal origin [43.75% (14/32) VS 17.65% (3/17)]. Endoscopic submucosal dissection [67.5% (27/40)] and transanal endoscopic microsurgery [25.0% (10/40)] were the major treatment method, but there were no significant differences in endoscopic ultrasonography manifestations and pathological grading of R-NENs between these two surgical procedures. Conclusion:There is no significant difference in endoscopic ultrasonography manifestations and pathological grade of R-NENs between deep mucosal origin and submucosal origin, suggesting that the prognosis is similar between the two types. It is no significant influence of endoscopic ultrasonography manifestations of R-NENs at different levels of origin.
