超声双重造影在胃癌术前诊断和临床分期的初步应用研究

Preliminary clinical use of double contrast-enhanced ultrasonography in diagnosis and preoperative staging of gastric cancer

目的探究超声双重造影在胃癌术前诊断和临床TNM分期中的应用价值。方法对浙江大学医学院附属第二医院普外科2011年7月至2011年9月期间入院的13例胃癌患者术前进行胃超声双重造影检查及TNM分期,并与术后病理作对照分析。结果超声双重造影检查对胃癌诊断准确率为100%(13/13),包括早期胃癌1例,进展期胃癌12例;对胃癌浸润深度分期总符合率为76.9%(10/13),检出癌灶直接浸润肝脏2例、网膜1例,3例浸润深度出现偏差的肿瘤均位于胃底或胃大弯;对淋巴结转移阳性的诊断准确率为66.7%(2/3),对淋巴结转移与否诊断的总体符合率为92.3%(12/13)。结论超声双重造影对胃癌的诊断以及术前临床分期具有较高的准确率,可做为进展期胃癌术前常规筛查手段,但对于胃大弯和胃底部病灶的TNM分期符合率相对偏低。

Objective To evaluate the preliminary clinical use of double contrast-enhanced ultrasonography using oral and intravenous contrast agents in diagnosis and preoperative staging of gastric cancer.Methods Double contrast-enhanced ultrasonography using oral and intravenous contrast agents was performed in 13 patients with gastric cancer.The diagnosis and preoperative staging evaluated by double contrast-enhanced ultrasonography were compared with postoperative pathologic outcomes.Results The accuracy of double contrast-enhanced ultrasonography for diagnosis of gastric cancer was 100% including one case with early and 12 with advanced gastric carcinoma.The accuracy for tumor invasion depth(T staging) was 76.9%(10/13) including 3 incorrect cases with tumors located in the fundus and greater curvature of the stomach respectively.The accuracy for peri-gastric lymph node metastasis was 66.7%(2/3) and the overall coincidence of peri-gastric lymph node involvement or not was 92.3%(12/13).Conclusions Double contrast-enhanced ultrasonography is useful for diagnosis and preoperative staging of gastric cancer.The accuracy for clinical TNM staging is comparatively low for early gastric cancer and tumors located in the greater curvature and fundus of the stomach.