Endoscopic Incidence of Upper Gastrointestinal Submucosal Tumors and Endosonographic Findings

PURPOSE: Gastrointestinal submucosal tumors(SMTs) are usually asymptomatic and they have been found accidentally during a surgery, autopsy or diagnostic procedure. But recently, the upper gastrointestinal(UGI) endoscopy has been frequently performed for the purpose of routine health check-ups and the trend of detecting SMTs has been increased, but no study has been conducted on the incidence rate. So, the authors investigated the endoscopic incidence of UGI SMTs out of the UGI endoscopic examinations that were conducted for the purpose of routine health check-ups at the Ajou medical center, and the originating layer of the tumor was investigates in cases where endoscopic ultrasonography(EUS) was performed. METHOD: The endoscopic findings of the patients, who had UGI endoscopic endoscopic examination as a routine health check-up at the Ajou Medical Center from March 1, 2003 to December 31, 2007, were reviewed retrospectively. The SMTs were defined as a lesion if it protruded into the lumen, covered with normal mucosa, and the protrusion stayed intact even when the lesion was compressed by endoscopic forceps. The gastrointestinal tract is comprised of 5 layers showing different echogenicity under endoscopic ultrasonography; The first layer is an entry echo and mucosa, the second is a mucosa, the third is submucosa, the fourth layer is a muscularis propria, and the fifth layer is serosa and exit echo. Of the patients who received EUS after being diagnosed with SMTs after receiving and endoscopic examination, each lesion was classified by following the endosonographic originating layer system. RESULT: Among the 48926 patients who received UGI endoscopic examinations, 707 patient(1.45%) were diagnosed with SMTs. The number of tumor occurrence by location resulted to show 220 esophageal SMTs(0.4%), 434 gastric SMTs(0.89%), and 53 duodenal SMTs(0.11%). 70 esophageal SMTs cases, where EUS was performed, showed that the tumors were most frequently found to have originated from the second layer of the esophageal wall. In cases of gastric SMTs, 163 patients received EUS and showed 112 cases of the tumors originated from the fourth layer of the gastric wall. In duodenal SMT cases, 19 patients received EUS and showed that their tumors had a high frequency rate of originating from the third layer of duodenal wall. CONCLUSION: The endoscopic incidence rate of UGI SMTs was 1.45%, including 0.45% in the esophagus, occurrence frequency of gastric SMTs in UGI tract recorded 0.89% in the stomach, and 0.11% in th bulb and 2nd portion of the duodenum in 48926 patients who had UGI endoscopic examination as a routine health check-up. The endoscopic incidence of SMTs increased according to patients` age and was more prevalent in the male sex.

Author dc:creator

• 김, 민철

Contributors dc:contributor

• 김, 진홍
• 대학원 의학과
• 200324251

• 상부 위장관
• 점막하종양
• 내시경

Language dc:language

ko

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000009321
000000009321

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/1824