【摘要】 目的分析上消化道间质瘤(Gastrointestinal stromal tumors,GISTs)及平滑肌瘤的超声内镜(Endoscopic Ultrasonography,EUS)及免疫组化特征以辅助鉴别诊断二者。方法以我院2013年9月至2017年9月的119例上消化道间质瘤和平滑肌瘤患者为研究对象,回顾性分析二者的内镜及免疫组化特征差异。结果 119例患者中,男性46例(38.66%),女性73例(61.34%)。普通胃镜下间质瘤和平滑肌瘤表面状况差异无统计学意义。病变位于食管51例(42.86%),食管病变大多为平滑肌瘤(66.67%),大多起源于固有肌层(52.94%)和黏膜肌层(39.22%);病变位于胃部68例(57.14%),胃部病变大多为间质瘤(89.70%),大多起源于固有肌层(92.65%)。平滑肌瘤主要起源于固有肌层(51.22%)和黏膜肌层(43.90%),多为低回声(78.05%)和中低混合回声(21.95%),大小多≤1cm(73.17%),大多数回声均匀(90.24%),具有SMA、Desmin高表达的特点;间质瘤主要起源于固有肌层(88.46%),大小多>2cm(48.72%)和≤1cm(30.77%),多为低回声(67.95%)和中低混合回声(30.77%),回声均匀者占60.26%,不均匀者占39.74%,具有CD117、Dog-1、CD34高表达的特点。结论间质瘤和平滑肌瘤在普通胃镜下表现相似,但可通过超声内镜及免疫组化辅助鉴别诊断。更多还原

【Abstract】 Objective To analyze the endoscopic ultrasonography(EUS) and immunohistochemical features of Gastrointestinal stromal tumors(GISTs) and leiomyomas to assist in differential diagnosis. Methods A total of 119 patients with upper gastrointestinal stromal tumors and leiomyomas from September 2013 to September 2017 in our hospital were studied. The endoscopic and immunohistochemical features of the two were analyzed retrospectively. Results Of the 119 patients, 46(38.66%) were males and 73(61.34%) were females. There were no significant differences statistically in the surface conditions of stromal tumors and leiomyomas under ordinary gastroscopy. The lesions were located in the esophagus in 51 cases(42.86%), and the esophageal lesions were mostly leiomyomas(66.67%). Most of them,originated from the muscularis propria(52.94%) and muscularis mucosa(39.22%); the lesions were located in the stomach in 68 cases(57.14%). Most of the stomach lesions were stromal tumors(89.70%), and most of them originated from the muscularis propria(92.65%). The leiomyomas originated mainly in the muscularis propria(51.22%) and muscularis mucosa(43.90%), mostly hypoechoic(78.05%) and mixed hypoechoic(21.95%), and the size was less than 1 cm mostly(73.17%). Most echoes were even(90.24%), characterized by high expression of SMA and Desmin; stromal tumors originated mainly in the muscularis propria(88.46%), size >2 cm(48.72%) and ≤1 cm(30.77%), mostly hypoechoic(67.95%) and middle-low mixed echo(30.77%), 60.26% were evenly echoed, and 39.74% were heterogeneous, with high expression of CD117, Dog-1, and CD34. Conclusion The stromal tumors and leiomyomas are similar under common gastroscopy but can be diagnosed differentially by endoscopic ultrasonography and immunohistochemistry.更多还原