1.陆军军医大学第二附属医院消化内科,重庆 400037
2.四川大学华西临床医学院2019级八年制临床医学专业,四川 成都 610041
Published:25 January 2024,
Received:15 December 2022,
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李建军,樊超强,杨歆等.小探头超声内镜在小直径低级别直肠神经内分泌肿瘤内镜手术中的应用[J].局解手术学杂志,2024,33(01):59-61.
LI Jian-jun,FAN Chao-qiang,YANG Xin,et al.Application of miniprobe endoscopic ultrasound in endoscopic surgery of small-diameter and low-grade rectum neuroendocrine neoplasm[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(01):59-61.
李建军,樊超强,杨歆等.小探头超声内镜在小直径低级别直肠神经内分泌肿瘤内镜手术中的应用[J].局解手术学杂志,2024,33(01):59-61. DOI: 10.11659/jjssx.12E022086.
LI Jian-jun,FAN Chao-qiang,YANG Xin,et al.Application of miniprobe endoscopic ultrasound in endoscopic surgery of small-diameter and low-grade rectum neuroendocrine neoplasm[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(01):59-61. DOI: 10.11659/jjssx.12E022086.
目的
2
评价小探头超声内镜(EUS)指导小直径(最大直径小于1 cm)低级别(G1级)直肠神经内分泌肿瘤(R-NEN)治疗的应用价值,为其临床应用和进一步研究提供循证医学证据和线索。
方法
2
回顾性分析2014年1月至2020年12月在本中心行内镜治疗的85例小直径低级别(G1级)R-NEN患者的临床资料,根据内镜治疗前是否行EUS检查将患者分为EUS组(37例)和对照组(48例)。比较2组患者内镜治疗后的切缘阳性率、并发症发生率、复发率、住院时间、住院费用、内镜治疗方式等指标。
结果
2
EUS组患者切缘阳性率显著低于对照组(
P
<
0.05)。2组患者并发症发生率、肿瘤复发率、住院时间及住院费用比较,差异均无统计学意义(
P
>
0.05)。2组患者内镜治疗方式比较,差异有统计学意义(
P
<
0.05)。
结论
2
对小直径低级别(G1级)R-NEN术前进行小探头EUS检查评估病变深度,并根据其结果选择内镜手术方式,可明显降低切缘肿瘤的残留风险。
Objective
2
To evaluate the value of miniprobe endoscopic ultrasound (EUS) in guiding endoscopic treatment of small-diameter (maximum diameter less than 1 cm) and low-grade (G1 grade) rectum neuroendocrine neoplasm (R-NEN), and to provide evidence and clues for its clinical application and further research.
Methods
2
The clinical data of 85 cases of low-grade (G1 grade) R-NEN with a maximum diameter of less than 1 cm who underwent endoscopic treatment in our center from January 2014 to December 2020 were retrospectively analyzed. The patients were divided into the EUS group (37 cases) and control group (48 cases) according to whether EUS was performed before endoscopic treatment. The positive rate of incision margin, the incidence of complications, the recurrence rate, the hospital stay, the cost of hospitalization and endoscopic therapy were compared between the two groups.
Results
2
The positive rate of incision margin in the EUS group was significantly lower than that in control group (
P
<
0.05). There was no significant difference in the incidence of complications, tumor recurrence rate, hospital stay or hospital costs between the two groups (
P
>
0.05). There was statistically significant difference in the endoscopic therapy between the two groups (
P
<
0.05).
Conclusion
2
Evaluating the lesion depth of small-diameter and low-grade (G1 grade) R-NEN before surgery by miniprobe EUS and selecting endoscopic surgery according to its results of can significantly reduce the residual risk of resection margin tumors.
小探头超声内镜直肠神经内分泌肿瘤精准治疗
miniprobeendoscopic ultrasoundrectumneuroendocrine neoplasmprecision therapy
Taghavi S,Jayarajan SN,Powers BD,et al.Examining rectal carcinoids in the era of screening colonoscopy:a surveillance,epidemiology,and end results analysis[J].Dis Colon Rectum,2013,56(8):952-959.doi:10.1097/DCR.0b013e318291f512http://dx.doi.org/10.1097/DCR.0b013e318291f512.
Fahy BN,Tang LH,Klimstra D,et al.Carcinoid of the rectum risk stratification (CARRS):a strategy for preoperative outcome assessment[J].Ann Surg Oncol,2007,14(5):1735-1743.doi:10.1245/s10434-006-9311-6http://dx.doi.org/10.1245/s10434-006-9311-6.
Modlin IM,Kidd M,Latich I,et al.Current status of gastrointestinal carcinoids[J].Gastroenterology,2005,128(6):1717-1751.doi:10.1053/j.gastro.2005.03.038http://dx.doi.org/10.1053/j.gastro.2005.03.038.
Ellis L,Shale MJ,Coleman MP.Carcinoid tumors of the gastrointestinal tract:trends in incidence in England since 1971[J].Am J Gastroenterol,2010 ,105(12):2563-2569.doi:10.1038/ajg.2010.341http://dx.doi.org/10.1038/ajg.2010.341.
Lawrence B,Gustafsson BI,Chan A,et al.The epidemiology of gastroenteropancreatic neuroendocrine tumors[J].Endocrinol Metab Clin North Am,2011,40(1):1-18.doi:10.1016/j.ecl.2010.12.005http://dx.doi.org/10.1016/j.ecl.2010.12.005.
Tsikitis VL,Wertheim BC,Guerrero MA.Trends of incidence and survival of gastrointestinal neuroendocrine tumors in the United States:a seer analysis[J].J Cancer,2012,3:292-302.doi:10.7150/jca.4502http://dx.doi.org/10.7150/jca.4502.
Janson ET,Knigge U,Dam G,et al.Nordic guidelines 2021 for diagnosis and treatment of gastroenteropancreatic neuroendocrine neoplasms[J].Acta oncologica,2021,60(7):931-941.doi:10.1080/0284186X.2021.1921262http://dx.doi.org/10.1080/0284186X.2021.1921262.
Ramage JK,De Herder WW,Delle Fave G,et al.Enets consensus guidelines update for colorectal neuroendocrine neoplasms[J].Neuroendocrinology,2016,103(2):139-143.doi:10.1159/000443166http://dx.doi.org/10.1159/000443166.
Shah M,Goldner W,Benson A,et al.Neuroendocrine and adrenal tumors,version 2.2021,NCCN clinical practice guidelines in oncology[J].J Natl Compr Canc Netw,2021,19(7):839-868.doi:10.6004/jnccn.2021.0032http://dx.doi.org/10.6004/jnccn.2021.0032.
Zhou X,Xie H,Xie L,et al.Factors associated with lymph node metastasis in radically resected rectal carcinoids:a systematic review and meta-analysis[J].J Gastrointest Surg,2013,17(9):1689-1697.doi:10.1007/s11605-013-2249-7http://dx.doi.org/10.1007/s11605-013-2249-7.
Brand M,Reimer S,Reibetanz J,et al.Endoscopic full thickness resection vs.transanal endoscopic microsurgery for local treatment of rectal neuroendocrine tumors-a retrospective analysis[J].Int J Colorectal Dis,2021,36(5):971-976.doi:10.1007/s00384-020-03800-xhttp://dx.doi.org/10.1007/s00384-020-03800-x.
Lee HS,Moon HS,Kwon IS,et al.Comparison of conventional and modified endoscopic mucosal resection methods for the treatment of rectal neuroendocrine tumors[J].Surg Endosc,2021,35(11):6055-6065.doi:10.1007/s00464-020-08097-zhttp://dx.doi.org/10.1007/s00464-020-08097-z.
Jeon SM,Lee JH,Hong SP,et al.Feasibility of salvage endoscopic mucosal resection by using a cap for remnant rectal carcinoids after primary EMR[J].Gastrointest Endosc,2011,73(5):1009-1014.doi:10.1016/j.gie.2010.12.029http://dx.doi.org/10.1016/j.gie.2010.12.029.
Mi JW,Wang JQ,Liu J,et al.The value of endoscopic ultrasonography in the endoscopic resection of gastrointestinal stromal tumors[J].Int J Gen Med,2021,14:5149-5157.doi:10.2147/IJGM.S319762http://dx.doi.org/10.2147/IJGM.S319762.
中华医学会消化病学分会胃肠激素与神经内分泌肿瘤学组.胃肠胰神经内分泌肿瘤诊治专家共识(2020·广州)[J].中华消化杂志,2021,41(2):76-87.doi:10.3760/cma.j.cn311367-20210104-00007http://dx.doi.org/10.3760/cma.j.cn311367-20210104-00007.
Yoshikane H,Tsukamoto Y,Niwa Y,et al.Carcinoid tumors of the gastrointestinal tract:evaluation with endoscopic ultrasonography[J].Gastrointest Endosc,1993,39(3):375-383.doi:10.1016/s0016-5107(93)70109-1http://dx.doi.org/10.1016/s0016-5107(93)70109-1.
Kiyonori K,Tomoe K,Shigeru Y,et al.Indications of endoscopic polypectomy for rectal carcinoid tumors and clinical usefulness of endoscopic ultrasonography[J].Dis Colon Rectum,2005,48(2):285-291.doi:10.1007/s10350-004-0765-yhttp://dx.doi.org/10.1007/s10350-004-0765-y.
Yoshida M.Endoscopic assessment of invasion of colorectal tumors with a new high frequency ultrosound probe[J].Gastrointest Endosc,1994,41(6):587-592.doi:10.1016/s0016-5107(95)70196-6http://dx.doi.org/10.1016/s0016-5107(95)70196-6.
Fu KI,Mashimo Y,Matsuda T,et al.Is endoscopic ultrasonography necessary for depth evaluation of rectal carcinoid tumors <or=10 mm?[J].Dis Colon Rectum,2006,49(8):1238-1239.doi:10.1007/s10350-006-0589-zhttp://dx.doi.org/10.1007/s10350-006-0589-z.
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