胃亚皮质病变的方法:从差异诊断到组织学确认
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea.
The Korean journal of helicobacter and upper gastrointestinal research
|September 11, 2025
概括
准确诊断胃亚皮质病变 (SELs) 是至关重要的. 内镜超声波 (EUS) 有助于表征,而粘膜切口辅助活检 (MIAB) 和EUS引导细针活检 (FNB) 等技术可以改善组织获取以确定诊断.
科学领域:
- 胃肠病学 胃肠病学
- 内镜诊断的诊断方法
- 在瘤学瘤学.
背景情况:
- 由于内镜查,胃亚皮质病变 (SELs) 的检测率正在上升.
- 虽然通常是良性的,但一些SEL,如胃肠道瘤,是恶性的,需要准确的诊断.
- 粘膜下部位置阻碍了传统的活检,使得先进的技术是必不可少的.
研究的目的:
- 审查当前对胃SEL的理解和基于证据的指导方针.
- 为临床医生提供诊断胃SEL的实际指导.
- 总结胃SEL的诊断和组织采集技术.
主要方法:
- 基于证据的指导方针和关于胃SEL的最新研究的审查.
- 关于用于病变特征的内镜超声波 (EUS) 的讨论 (来源层,回声性,内部特征).
- 组织采集技术的评估:粘膜切口辅助活检 (MIAB) 和EUS引导的细针活检 (FNB).
主要成果:
- EUS对于表征胃SEL来说至关重要.
- MIAB显示了~89%的诊断收益率,特别是对于小于20毫米的病变.
- FNB提供了足够的组织用于免疫组织化学分析.
结论:
- 考虑到EUS发现,患者因素和机构能力,对胃SEL进行量身定制的管理是必不可少的.
- 对于SEL组织采集的国际指导方针存在差异.
- 准确的诊断依赖于将EUS与适当的活检技术相结合.
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