纤维结肠镜和直肠指诊对判定直肠癌距肛缘距离的准确性分析

Comparison between Rectal Palpation and Colonoscopy for Accurately Predicting the Distance between Rectal Cancer and Anal Edge

目的:分析纤维结肠镜和直肠指诊对判定直肠癌距肛缘距离准确性,探讨其可能的矫正方法。方法:对比分析64例行Milse术的直肠癌患者术前经直肠指诊测得的肿瘤距肛缘距离(简称“指诊距离”)、纤维结肠镜测得的肿瘤距肛缘距离(简称“肠镜距离”)及术后新鲜标本测得的癌肿距肛缘距离(简称“实际距离”)。将指诊距离分为两组。A组29例:指诊距离≤4cm;B组35例:7cm≥指诊距离>4cm,分别与实际距离进行统计学分析。结果:肠镜距离与实际距离差异有统计学意义(P<0.01);A组指诊距离与实际距离的差异无统计学意义(P>0.01),B组指诊距离与实际距离的差异有统计学意义(P<0.01),且呈直线相关关系。回归方程为:实际距离=指诊距离×1.3-1。结论:指诊距离相对于肠镜距离能更准确的反映实际距离;A组指诊距离能较好反映实际距离,B组应用矫正公式后可相对准确的推算实际距离。

Objective： To analvze the accuracy of the distance predicted between rectal caneer and the anal edge using rectal palpation and colonoscopy. Methods： Parallel analyses were eonducted for 64 cases with rectal cancer to determine the preoperative distance between the tumor and the anal edge as measured by reetal palpation （designated as ＂T distance＂）, eolonoscopy （＂F distance＂） and the postoperative exeised specimen （＂E distance＂）. The T distanee measurements were divided into two groups： Group A consisted of 29 samples that had a T distance ≤4cm and Group B consisted of 35 samples that had a T distance between 4 cm and 7 cm. Results： There was no signifieant difference between the F and the E distance （P〈0.01）. In group A, there was no significant difference between the T and the E distance （P〉0.01）, but there was a significant difference between the T and the E distance in group B （P〈0.01）, with a linear correlation. The equation for correction adjusts the E distance to ＂T distance times 1.3-1＂. Conclusion： T distance is more accurate than F distance. T distance in group A is more accurate than that in group B. In group B, the calculation of E distance can be more aceurate after applying the rectification formula.