小探头超声内镜在结直肠侧向发育型肿瘤浸润深度评估中的应用

Application of miniprobe ultrasonic endoscope in evaluating the depth of invasion in colorectal laterally spreading tumors

摘要:

目的 分析小探头超声内镜评估结直肠侧向发育型肿瘤（LST）黏膜下层浸润的准确率及其影响因素。方法 回顾性分析2018年6月－2021年8月就诊于该院内镜中心拟行内镜黏膜下剥离术（ESD）治疗的213例结直肠LST患者（共268处病灶）的临床资料。总结结直肠LST的临床病理特征和小探头超声内镜检查结果，分析超声内镜检查准确率及其影响因素。结果 小探头超声内镜评估准确率为93.28%，不同病变表面形态的小探头超声内镜评估准确率比较，差异有统计学意义（P = 0.000）。多因素Logistic回归分析显示，结节混合型和假凹陷型病变是影响小探头超声内镜评估准确率的危险因素。结论 结直肠LST是一种特殊的肿瘤，小探头超声内镜评估其浸润深度，具有较高的准确率。病变表面形态是影响小探头超声内镜评估准确率的危险因素，当病变为结节混合型和假凹陷型时，易影响其评估准确率。

Abstract:

Objective To analyze the accuracy and influencing factors of miniprobe ultrasonic endoscope in evaluating submucosal infiltration of colorectal laterally spreading tumor (LST).Method A retrospective analysis was conducted on the clinical data of 213 patients (268 lesions in total) with colorectal LST who underwent endoscopic submucosal dissection (ESD) treatment from June 2018 to August 2021. We summarized the clinical pathological characteristics and miniprobe ultrasonic endoscope examination results of LST, then analyzed the accuracy of miniprobe ultrasonic endoscope examination and the risk factors affecting the accuracy of miniprobe ultrasonic endoscope examination.Results The accuracy rate of miniprobe ultrasonic endoscope examination was 93.28%, and there was a statistically significant difference in the accuracy rate of miniprobe ultrasonic endoscope examination between different lesion surface morphologies (P = 0.000). Multivariate Logistic regression analysis showed that mix-ed nodule and false depression lesions were risk factors for inaccurate EUS assessment.Conclusion Colorectal LST is a special type of tumor, and miniprobe ultrasonic endoscope examination has a high accuracy in evaluating its infiltration depth. The surface morphology of the lesion is a risk factor that affects the accuracy of miniprobe ultrasonic endoscope examination. When the lesion is a nodule mixed type or pseudo depressed type, it can easily lead to inaccurate miniprobe ultrasonic endoscope examination.