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[在结肠镜检查失败后的诊断策略:结肠癌中的内镜超声波引导细针活检]

Calixto Duarte-Chang¹, Julio Zúñiga Cisneros², Ramiro Da Silva Rodriguez¹

¹Servicio de Gastroenterología, Hospital San Miguel Arcángel, Panamá, República de Panamá; Sistema Nacional de Investigación (SIN), Panamá, República de Panamá.

Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru

|August 13, 2025

概括

以内镜超声波 (EUS) 引导的细针活检 (FNB) 提供了一个安全的替代方案,用于在标准结肠镜检查失败时诊断困难的结肠病变. 这种技术在一个具有挑战性的情况下成功诊断了结肠腺癌,证明了它的可行性.

科学领域:

胃肠病学胃肠病学
内镜手术进行内镜手术
在瘤学瘤学.

背景情况:

常规的结肠镜检查与囊活检是诊断结肠癌的标准,但对于深层或狭窄的病变可能是负面的.
以内镜超声波 (EUS) 引导的细针活检 (FNB) 在标准方法不足时,为病理诊断提供了可行的替代方案.

研究的目的:

突出EUS指导FNB用于诊断结肠病变的实用性,特别是当结肠镜检查失败时.
提出一个案例,证明EUS-FNB在结肠腺癌诊断中的可行性.

主要方法:

一名62岁的男性患有结肠瘤,接受了常规结肠镜检查,但没有成功.
以EUS为指导的FNB通过胃经路线进行,以获得组织样本.
对活检样本的组织病理学分析证实了诊断.

主要成果:

在EUS的指导下,FNB成功地从位于脏曲处的结肠质中获得了组织.
组织学检查证实了结肠腺癌的存在.
经胃的EUS-FNB方法被证明是可行的诊断结肠病变.

结论:

由EUS指导的FNB是一种安全可靠的方法,用于对胃肠病变的病理诊断,包括具有挑战性的结肠瘤.
这种技术在常规结肠镜检查结果不确定或在技术上很困难的情况下特别有价值.
EUS-FNB为深层或狭窄的结肠病变提供了关键的诊断选择,改善了患者管理.

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