声辐射脉冲成像技术对进展期胃癌临床病理分型的初步研究

Pilot study of acoustic radiation force impulse imaging for clinical pathological typing of advanced gastric cancer

目的 探讨声触诊组织定量分析（VTQ）对进展期胃癌临床病理类型的评估价值.方法 应用声辐射力脉冲成像技术（ARFI）对56例胃癌患者进行超声弹性量化检测,所有病例按临床病理类型分为高中分化腺癌（14例）、非高中分化腺癌（42例）两组.将VTQ测值与临床病理类型进行对照,分析进展期胃癌VTQ值与其临床病理类型的关系.结果 高中分化腺癌组VTQ值明显低于非高中分化腺癌组[（1.49±0.44）m/s对（2.12±0.45）m/s],差异有统计学意义（t=-4.53,P＜0.05）.根据ROC曲线计算曲线下最大面积,以胃癌组织VTQ＞1.795 m/s作为胃癌非中高分化类型的诊断标准,其灵敏度为78％,特异度为86％,Youden指数为0.64,且具有较高的重复可靠性（Kappa=0.81）.结论 VTQ技术对术前评估进展期胃癌的临床病理类型有一定帮助.

Objective To explore the value of virtual touch tissue quantification （VTQ） in the evaluation of clinical pathological typing of advanced gastric cancer.Methods Fifty six patients who had been diagnosed as gastric cancer were examined using acoustic radiation force impulse.According to clinical pathological typing,all cases were divided into highly-moderately differentiated adenocarcinoma （14 cases） and non-highly-moderately differentiated adenocarcinoma （42 cases）.A comparison with clinical pathologic results was made after surgery.The correlation of VTQ results and clinical pathological typing of gastric cancer was analyzed.Results The VTQ value of highly-moderately differentiated adenocarcinoma was lower than that of non-highly-moderately differentiated adenocarcinoma [（1.49 ± 0.44） m/s vs （2.12 ± 0.45） m/s],with statistical significance（ t =-4.53,P 〈0.05）.According to the maximum area under the ROC curve,the cutoff value of VTQ was 1.795 m/s,the sensitivity and specificity were 78% and 86%,respectively,the Youden＇s index was 0.64,and with high reproducibility（Kappa =0.81）.Conclusions VTQ could initial estimate the clinical pathological typing of advanced gastric cancer before operation. ：