深在性囊性胃炎内镜下的特征性表现及治疗策略:基于单中心的回顾性研究

摘要

Objective:To summary the endoscopic features and the effectiveness of endoscopic treatment for gastritis cystica profunda(GCP).Methods:We retrospectively analyzed 40 cases of GCP who underwent endoscopic treatment in our center from October 2011 and October 2016.Results:The main endoscopic manifestation of GCP was the type as submucosal tumor(45%).Endoscopic ultrasound had high diagnostic value for this type before operation.Only 20% patients were preoperatively diagnosed as GCP.There was no recurrence in the follow-up.12.5% GCP associated with early gastric cancer (EGC)was confirmed by final pathology,the main endoscopic manifestation was Ⅱa+ Ⅱc type.After the endoscopic therapy, there was no recurrence in the follow-up.Conclusions:GCP associated EGC is not rare.Elderly male patient,Ⅱa+ Ⅱc type, lesion in cardia and prior gastrectomy might be the risk factors for development of EGC in GCP.Endoscopic submucosal resection can be recommended as an effective and minimally invasive treatment for GCP with or without EGC.%目的:基于单中心数据探讨深在性囊性胃炎(gastritis cystica profunda,GCP)内镜下的特征性表现及诊疗策略.方法:回顾性分析复旦大学附属中山医院内镜中心2011年10月至2016年10月内镜治疗后经病理确诊的40例GCP患者的临床资料,总结其内镜下特征性表现,并对其中GCP合并早期胃癌的患者进行单独分析.结果:GCP内镜下表现以黏膜下隆起型为主(18/40,45%),术前超声胃镜对黏膜下隆起型的 GCP有较高的诊断价值.术前诊断为GCP而接受治疗的比例为20%,内镜治疗后随访均无复发.5例(12.5%)GCP患者合并有早期胃癌,主要表现为黏膜病变型(Ⅱa+ Ⅱc型),接受内镜下治疗后随访均无复发.结论:GCP患者内镜下主要表现为黏膜下隆起型;GCP患者常合并早期胃癌,老年男性、既往远端胃切除史、病灶位于贲门、内镜表现为Ⅱa+ Ⅱc型可能是GCP合并早期胃癌的高危因素;无论是否合并早期胃癌,内镜黏膜下剥离术(ESD)治疗都是一种安全、有效的微创治疗方式.