The Clinical And Pathological Features Analysis Of The Upper Gastrointestinal Submucosal Lesions

Objective:Advances in endoscopic ultrasonography and prevalence of routine endoscopy have increased the rate of SML(upper gastrointestinal submucosal lesions,SML)detection.There were differences in the treatment and prognosis of different pathological types of SML.This paper mainly to analyze the differences in the ages,the source level,and the pathological types of different locations of SML,to improve the diagnosis of the SML.Methods: We retrospectively collected 295 cases of upper gastrointestinal submucosal lesions,which were evaluated by endosocopic ultrasonography and pathology after surgery from January 2015 to December 2016 in our department.Observe the manifestations of SML in routine endoscopic.The features about the different locations of SML by endoscopic ultrasonography,such as the size,echo performance,etc,and pathology after surgery.To analyze the significant differences in the constituent ratio of gender,age,source level and pathological types,and,the differences in the results of immunohistochemical between stromal tumor and leiomyoma.Results: Among 295 cases(male/female ratio was 0.74,median age was 51.3±10.9,median diameter was 9.36±4.47mm),139 lesions were in the esophagus,17 lesions were in the preventriculus,34 lesions in the gastric fundus,32 lesions in the gastric body,59 lesions in the gastric sinus and 14 lesions in the duodenum.The esophagus(47.1%)and the stomach(48.1%)was most common in SML,the gastric sinus(20%)was most common in the stomach.There were significant differences in the constituent ratio of age,source level and pathological types of different locations of SML(P<0.05).The SML diameter in the esophagus and duodenum was smaller than that in other parts,the difference was statistically significant(P<0.05).There was no significant difference in the gender of the patients(P> 0.05).There were differences in the features of endoscopic ultrasonography of leiomyoma,ectopicpancreas,gastrointestion lastronmal tumors and lipoma.The positive rate of SMA in leiomyoma was 98.5%,The positive rate of CD117,CD34,DOG-1 in gastrointestion lastronmal tumors was 85.7%,78.5%,78.5% respectively.Conclusion: There were differences in the constituent ratio of age,source level and pathological types of different locations of SML.Endoscopic ultrasonography is an effective method for the diagnosis of Upper gastrointestinal submucosal lesions.Ectopicpancreas and lipoma occurs in the submucosal lipoma,leiomyoma and gastrointestion lastronmal tumors was the muscularis mucosa and the muscularis propria respectively.CD117,CD34,DOG-1,SMA was the important marker of immune in stromal tumor and leiomyoma identification.