Endoscopic Ultrasonographic Features of Rectal Neuroendocrine Neoplasms and its Application Value
10.3969/j.issn.1008-7125.2024.08.001
- VernacularTitle:直肠神经内分泌肿瘤的内镜超声特征及其应用价值
- Author:
Mengyuan HU
1
;
Ming LI
1
;
Shiyun TAN
1
Author Information
1. 武汉大学人民医院消化内科(430060)
- Publication Type:Journal Article
- Keywords:
Rectal Neuroendocrine Neoplasms;
Endoscopic Ultrasonography;
Diagnosis
- From:
Chinese Journal of Gastroenterology
2024;29(8):449-453
- CountryChina
- Language:Chinese
-
Abstract:
Background:With the development of endoscopic techniques,the incidence of rectal neuroendocrine neoplasms(R-NEN)is increasing year by year,and its atypical symptoms and risk of metastasis make early and accurate localization of its primary site essential for its diagnosis and treatment.Aims:To explore the endoscopic ultrasonographic manifestations of R-NEN,compare the consistency between endoscopic ultrasonography(EUS)and pathological diagnosis,and analyze the reasons for these differences.Methods:Patients with pathologically confirmed R-NEN from January 2016 to December 2023 at Renmin Hospital of Wuhan University were recruited retrospectively in this study.The clinical characteristics and the microscopic manifestations of the lesions were analyzed,the diagnostic ability of EUS and postoperative pathology on the infiltration depth of the lesions were compared,and the factors affecting the diagnostic accuracy of EUS were analyzed.Results:A total of 127 patients with R-NEN were included in this study,54.3%(69/127)were male patients,with an average age of(51.00±12.30)years old.Most of the lesions seen microscopically were smooth spherical or hemispherical elevations located in the mucosal-submucosal layer of the rectum,with an average size of(0.77±0.62)cm,and a distance of(6.58±2.51)cm from the anal verge.The diagnostic compliance rate of EUS for lesions involving the submucosa was 98.3%(116/118),and the diagnostic accuracy for the intrinsic muscular layer and above was 55.6%(5/9).The difference of Kappa's consistency test between the two was statistically significant(P<0.05).The diagnostic accuracy of EUS for lesions of 10-20 mm(OR=5.068,95%CI:1.34-19.12,P=0.017)was acceptable,whereas lesions located in the upper rectum(OR=0.05,95%CI:0.01-0.75,P=0.031)and involving to the intrinsic muscular layer of the intestinal wall and above(OR=0.05,95%CI:0.01-0.59,P=0.017)could negatively affect its diagnostic accuracy.Conclusions:EUS has a high localization accuracy for R-NEN lesions,and can be used as a key method for the initial diagnosis of suspected R-NEN.For lesions located in the upper rectum and with deeper infiltration levels,a more standardized operation with more detailed analysis are recommended.
