对直肠内超声诊断用于直肠癌术前分期的探讨

Assessment of transrectal ultrasonography for preoperative T staging of rectal carcinoma

目的评估直肠内超声诊断(transrectalultrasonography,TRUS)对直肠癌术前T分期的价值。方法收集原发性直肠癌45例。观察肿块大小、形态、回声、方位、浸润周径、深度及邻近组织脏器受累。结果45例中,TRUS检出42例;超声分期(uT)与病理分期(pT)相符32例,符合率76%。TRUS所测肿瘤长、短径与pT无明显关系(P=0.083、0.499),而侵犯周径则与pT有关(P=0.015)。结论对于多数直肠癌患者,TRUS是其T分期的有效手段;难以判断肿瘤浸润深度时,结合侵犯周径可提高分期准确性。

Objective To evaluate the value of transrectal ultrasonography （TRUS） in the preoperative T staging of rectal carcinoma. Methods Forty-five patients with primary rectal carcinoma were examined with TRUS. The size, shape, echo levels, orientation, infiltration depth, and extra-rectal invasion of lesions were observed. Results Of 45 cases, 42 were detected to have tumors by TRUS. The consistency of staging with TRUS （uT） and with pathology （pT） was 76%. There was the significant relation of circumferential wall invasion of tumors with pT （P=0. 015）, however, no relation of longitudinal and transverse dimensions measured on TRUS images with pT was demonstrated. Conclusion TRUS is a useful method for most patients in the T staging of rectal carcinoma before surgery. Circumferential wall invasion of tumors can be used in prediction of the depth of wall invasion when the depth cannot be depicted.