| Aim:By comparing the endoscopic ultrasonography diagnosis of upper gastrointestinal submucous lesions with the pathological results after ESD,evaluated the value of endoscopic ultrasonography in the diagnosis of upper gastrointestinal submucous lesions and the significance of guiding the choice of treatment.Methods:Retrospectively collected and analyzed 78 patients who underwent endoscopic ultrasonography in the endoscopy room of the Affiliated Hospital of Taishan Medical College from August 2016 to December 2018,and obtained pathological diagnosis after ESD treatment.Ultrasound endoscopy and clinical and pathological data were used to compare and analyze the coincidence rate of upper gastrointestinal submucosal lesions under endoscopic diagnosis and pathological diagnosis obtained after ESD treatment,as well as related factors affecting the accuracy of endoscopic diagnosis.Results:1.Collect and organize 78 general data of patients with submucosal lesions of the upper digestive tract,endoscopic ultrasonography and ESD pathological results and other related medical records.Among 78 patients,35 males and 43 females,age distribution Between 42-74 years old,the average age is 54.1±7.8 years.Of the 78 cases of upper gastrointestinal submucosal lesions,27 were located in the esophagus,accounting for34.6% of the total;47 cases in the stomach,accounting for 60.3% of the total;and 4 cases in the duodenum,accounting for 5.1% of the total.The size of the lesion was recorded by the endoscopic diameter of the lesion as measured by endoscopic ultrasonography.The lesion size ranged from 0.8 cm to 4.4 cm in 78 cases,with an average size of 1.8±0.5 cm.2.Analysis of submucosal lesions in the upper digestive tract: There were 78 lesions in this study.Among them,leiomyomas mostly occurred in the esophagus and stomach.The pathological results obtained after ESD treatment confirmed that there were 29 cases of leiomyoma,including 20 cases.Located in the esophagus,accounting for 69.0%(20/29),9 cases in the stomach,accounting for 31.0%(9/29);stromal tumor mainly occurred in the stomach,31 cases of stromal tumor confirmed by pathology after ESD,of which 28 The case occurred in the stomach,accounting for 90.3%(28/31).Under endoscopic ultrasonography,leiomyomas mostly originate from the mucosal muscle layer or the muscularis propria.The stromal tumor originates from the muscularis propria,and both of them are mostly hypoechoic light clusters;the lipoma mainly manifests as high echo.Most originated from the submucosa;the main feature of the ectopic pancreas is hypoechoic or mixed echogenic lesions originating from the submucosa.3.Ultrasound endoscopic diagnosis of 78 cases was compared with pathological results after ESD: There were 63 cases with pathological findings consistent with endoscopic ultrasonography and ESD.The total accuracy of EUS diagnosis was 80.8%(63/78).For stromal tumors,leiomyomas,lipomas,ectopic pancreas,and early cancer,the accuracy of endoscopic diagnosis is 75%(27/36),82.1%(23/28),and 100%(6/6),66.7%(2/3),100%(5/5).The diagnostic accuracy of EUS for submucosal lesions occurring in the esophagus,stomach and duodenum was 85.1%(23/27),78.7%(37/47),and 75%(3/4),respectively.The lesion size was recorded according to the long diameter of the lesion.The average lesion size of EUS and pathological diagnosis was(1.8±0.5)cm,and the average size of the inconsistent lesion was(1.3±0.9)cm,P=0.001<0.05,the difference was statistically significant.The ROC curve was made by the size of the lesion and the endoscopic diagnosis.The area under the curve was 0.869,P<0.001,which was statistically significant.It can be considered that the lesion size and EUS diagnosis are correct.The rate is related,the larger the lesion,the easier it is to diagnose correctly.Conclusion:Ultrasound endoscopy can accurately assess the origin and nature of the submucosal lesions of the upper digestive tract,which can guide the choice of treatment methods for submucosal lesions of the upper digestive tract. |
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