胃超声造影与超声内镜对胃癌术前分期诊断意义的对比研究

Comparison of contrast-enhanced ultrasonography and endoscopic ultrasonography in preoperative staging of gastric cancer

目的对比胃超声造影与超声内镜(EUS)在胃癌术前分期诊断中的价值,以提供临床参考。方法经胃镜检查活检确诊为胃癌的52例患者术前分别进行超声造影和超声内镜检查,并与手术病理结果对照。结果超声造影对胃癌T分期的总准确率为69.2%,其中T150.0%,T260%,T376.4%,T484.6%;EUS的总准确率为78.8%,其中T183.3%,T270%,T382.3%,T476.9%。EUS对T1分期的准确率高于超声造影(P<0.05),其余T分期的准确率组间差异无统计学意义(P>0.05)。超声造影对胃癌术前N分期的总准确率为78.8%,其中N086.6%,N166.6%,N276.5%,N387.5%;EUS总准确率为57.6%,其中N093.3%,N158.3%,N241.1%,N325.0%。超声造影对N2和N3分期的准确率高于EUS(P<0.05,P<0.05)。超声造影对胃癌术前M分期的总准确率为92.3%,其中M0100%,M178.9%;EUS总准确率为63.4%,其中M081.8%,M131.6%。超声造影对M1分期的准确率亦高于EUS(P<0.05)。结论超声造影与超声内镜对胃癌术前分期诊断有较好的临床应用价值,对于中晚期病例,超声造影存在较大的优势。

Objective To compare clinical value of contrast-enhanced ultrasonography （CEUS） and endoscopic ultrasound （EUS） in preoperative staging of gastric cancer. Methods A total of 52 cases with gastric cancer pathologically confirmed by endoscopic biopsy were checked with CEUS and EUS preoperatively. Results In items of T stage, the accuracy for Tl-staging with EUS was significantly higher than that with CEUS （P〈0.05）. There were no significant differences in other T-stagings between CEUS and EUS （P〉0.05）. The accuracy for N2-staging, N3-staging and M1-staging with CEUS were significantly higher than those with EUS （P〈0.05）. Conclusion CEUS is better than EUS in preoperative TNM-staging of advanced gastric cancer, though both of them are valuable.