胃亚皮质病变<20毫米的内镜诊断:当前的策略和新兴的解决方案
Yosuke Minoda1,2, Shuzaburo Nagatomo1, Haruei Ogino1,3
1Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
概括
诊断小胃亚皮质病变 (<20毫米) 是一个挑战. 粘膜切口辅助活检 (MIAB) 是对内镜超声波导向组织采集 (EUS-TA) 的一个切实可行的替代方案,用于准确的诊断.
科学领域:
- 胃肠病学 胃肠病学
- 内镜诊断的诊断方法
- 胃肠道瘤学 胃肠道瘤学
背景情况:
- 小胃亚皮质病变 (<20毫米) 是常见的,其中一个显著的子集是潜在的恶性胃肠瘤 (GIST).
- 准确的组织学诊断对于这些病变的风险分层和治疗计划至关重要.
- 用内镜超声波引导的组织采集 (EUS-TA) 面临着小型病变的技术限制,影响诊断产量.
研究的目的:
- 审查和总结目前用于胃亚皮质病变 (SELs) <20mm的内镜诊断方法.
- 为了比较采样和非采样技术的有效性和局限性,用于诊断小SEL.
- 根据病变特征和临床背景,为选择适当的诊断方式提供见解.
主要方法:
- 对SELs<20mm的内镜诊断技术现有文献的叙述性综述.
- 采样方法的评估:内镜超声导向组织采集 (EUS-TA) 和粘膜切口辅助活检 (MIAB).
- 非采样技术的评估:对比度增强的EUS,弹性图像和人工智能 (AI) 辅助的图像分析.
主要成果:
- 粘膜切口辅助活检 (MIAB) 由于直接可视化和有针对性的采样,为小SEL提供了EUS-TA的可行替代方案.
- 非采样方式,如对比度增强的EUS,弹性图和人工智能辅助分析,提供了补充的诊断信息.
- 每种技术都有独特的优缺点,需要根据病变特征,内镜专家的专业知识和可用的资源进行量身定制的选择.
结论:
- 精确诊断小胃亚皮质病变 (<20mm) 需要对各种内镜技术的全面了解.
- 与传统的EUS-TA相比,粘膜切口辅助活检 (MIAB) 改善了小SEL的诊断产量.
- 非采样方式变得越来越重要,为改善诊断准确性提供了有价值的补充,用于管理小胃亚皮质病变.
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