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目的总结上消化道平滑肌肿瘤发病情况及其内镜特点，探讨其良、恶性病变的诊治方法。方法对２５年间经手术和病理证实的１５６例上消化道平滑肌肿瘤进行回顾性分析。结果１５６例上消化道平滑肌肿瘤中平滑肌瘤１２６例，平滑肌肉瘤３０例，内镜确诊率８１．４％。食管平滑肌瘤较多见，且多为≤２ ｃｍ的小平滑肌瘤（７８．２％）；７３．３％的平滑肌肉瘤表面有溃疡形成，而平滑肌瘤表面溃疡仅为１４．３％，两者差异显著（Ｐ＜０．０１）；肿瘤长径≤２ ｃｍ者７５．４％为平滑肌瘤，＞ ５ ｃｍ者７６．７％为平滑肌肉瘤。９５例直径≤ ２ ｃｍ的平滑肌瘤经内镜推顶圈套法切除，无严重并发症发生。结论食管小平滑肌瘤较多见；肿瘤大小及表面溃疡为内镜下鉴别平滑肌瘤与肉瘤的重要依据；内镜下推顶圈套法切除直径≤ ２ ｃｍ的平滑肌瘤安全、有效。
Objective To summarize the incidence and endoscopic features of upper gastrointestinal smooth muscle tumors and to explore the diagnosis and treatment of benign and malignant lesions. Methods A retrospective analysis of 156 cases of upper gastrointestinal smooth muscle tumors confirmed by operation and pathology in 25 years was performed. Results 156 cases of upper gastrointestinal smooth muscle tumors leiomyoma in 126 cases, leiomyosarcoma in 30 cases, endoscopic diagnosis rate of 81.4%. Esophageal leiomyoma more common, and mostly less than 2 cm of leiomyoma (78.2%); 73.3% of leiomyosarcoma surface ulceration, and leiomyoma surface ulcer was only 14.3% (P <0.01). 75.4% of patients with long diameter ≤2 cm were leiomyoma, 76.7% of patients with> 5 cm were leiomyosarcoma. Ninety-five cases of leiomyoma of diameter ≤ 2 cm were excised by endoscopic thrombolysis and no serious complication occurred. Conclusions Esophageal leiomyoma is more common; tumor size and surface ulceration are important evidences for differentiating leiomyomas and sarcomas under endoscopy. Laparotomy with endoscopic resection of leiomyoma of diameter ≤ 2 cm is safe and effective.