内镜超声检查对胃癌浸润深度淋巴结状况和可切除性术前评估的价值

Clinical Value of Endoscopic Ultrasonography in Preoperative Assessment of Invasive Depth,Lymph Node Status and Resectability for Patients with Gastric Carcinoma

目的 :探讨内镜超声检查 (EUS)在术前判断胃癌浸润深度、淋巴结状况和可切除性中的临床应用价值。方法 :对经胃镜活检证实的胃癌 12 4例术前行内镜超声检查 ,并与术后病理检查结果对照。结果 :EUS对胃癌 T分期 (浸润深度 )的判断准确率为 82 .4 % ,其中 T1 期为 86 .2 % ,T2 期为 72 .7% ,T3期为 88.9% ,T4 期为 73.9% ,其中 EUS鉴别粘膜和粘膜下癌的准确率为 6 5 .5 %。EUS对胃癌淋巴结状况的判断准确率、淋巴结转移的敏感性和特异性分别为 82 .1%、76 .3%和 89.4 %。EUS判断胃癌可切除性的敏感性和特异性分别为 98.1%和 77.8%。结论 :内镜超声检查对胃癌浸润深度、淋巴结状况和可切除性的术前评估具有较高的临床应用价值。

Objective:To study the clinical value of endoscopic ultrasonography (EUS) in preoperative assessment of invasive depth, lymph node status and resectability for patients with gastric carcinoma.Methods:EUS was performed in 124 patients with gastric carcinoma proved by means of biopsy, and the results were compared with postoperative pathologic findings.Results:The accuracy of EUS in determining the T stage(invasive depth) of gastric carcinoma was 82.4% (T 1 86.2%, T 2 72.7%, T 3 88.9%, T 4 73.9%), and the accuracy of EUS in differentiating mucosal cancer from submucosal cancer was 65.5%. The preoperative EUS diagnostic accuracy of lymph node status of gastric carcinoma was 82.1%, and the sensitivity and specificity were 76.3% and 89.4%, respectively. Resectability of gastric carcinoma was predicted correctly by EUS with a sensitivity of 98.1% and a specificity of 77.8%.Conclusion:The clinical value of EUS in preoperative assessment of invasive depth, lymph node status and resectability for patients with gastric carcinoma was relatively high.