■探讨直肠增生性息肉(rHP)误诊为直肠神经内分泌肿瘤(rNENs)的白光内镜及超声内镜(EUS)特征。在直径为5-10毫米的rNEN中,内镜检查结果不典型,其中一些与rHP相似,因此,将rNEN误诊为rHP并不少见。然而,rHP误诊为rNENs在文献中没有报道,这可以提醒临床医生这种可能性的存在,并避免过度治疗。
■收集2015年1月至2020年12月我院内镜诊断的直肠粘膜下肿瘤(SMT)245例,内镜诊断为可疑的直肠粘膜下肿瘤103例。对其形状进行了回顾性分析,颜色,血管扩张,以及在白光内窥镜下病变表面的边界,和来源,边界,和EUS的回声特征。我们还分析了rHP误诊为rNENs的内镜特征。内镜诊断和病理诊断分别由高级内镜专家和病理学家进行审查。采用χ2检验和Fisher精确概率法对计数数据进行检验和分析。
■共103例经内镜诊断为rNENs,其中75例(72.8%)为rNENs,8例(7.8%)为rHP。rNENs和rHP在性别方面没有显著差异,年龄,临床表现,病变的形状和颜色,血管表面扩张,和病变的位置。同时,在白光内镜下病变边界是否清晰有显著差异,和来源,回声,和EUS下病变的边界。
■某些rHP的形态与内窥镜检查下的rNEN相似。在白光内窥镜和光源下边界清晰,回声,EUS下的边界有助于rNENs和rHP的诊断。
UNASSIGNED: To explore the white light endoscopy and endoscopic ultrasonography (EUS) features of rectal hyperplastic polyps (rHP) misdiagnosed as rectal neuroendocrine neoplasms (rNENs). In rNENs with a diameter of 5-10 mm, the endoscopic findings are not typical and some of them are similar to rHP, so it is not uncommon to misdiagnose rNENs as rHP. However, misdiagnosis of rHP as rNENs has not been reported in the literature, which can alert clinicians to the existence of this possibility and avoid over-treatment.
UNASSIGNED: We collected 245 cases of rectal submucosal tumor (SMT) diagnosed by endoscopy in our hospital from January 2015 to December 2020 and 103 patients with suspected rNENs identified through endoscopy. A retrospective analysis was conducted of the shape, color, vascular dilatation, and boundary on the surface of the lesion under white light endoscope, and the source, boundary, and echo characteristics of EUS. We also analyzed the endoscopic features of rHP misdiagnosed as rNENs. Endoscopic diagnosis and pathological diagnosis were reviewed by a senior endoscopic expert and pathologist respectively. The counting data were tested and analyzed by χ2 test and Fisher exact probability method.
UNASSIGNED: A total of 103 cases of rNENs were diagnosed by endoscope, among whom 75 cases were confirmed as rNENs (72.8%) and 8 cases as rHP (7.8%) by histopathology. There was no significant difference between rNENs and rHP in terms of gender, age, clinical manifestation, shape and color of lesions, dilatation of blood vessels on the surface, and location of lesions. Meanwhile, there were significant differences in whether the boundary of the lesion was clear under white light endoscopy, and the source, echo, and boundary of the lesion under EUS.
UNASSIGNED: The morphology of some rHP is similar to rNENs under endoscopy. The boundary is clear under white light endoscopy and the source, echo, and boundary under EUS are helpful for the diagnosis of rNENs and rHP.