高频微探头超声内镜检查在结直肠癌术前TN分期中的价值

Value of High Frequency Endoscopic Ultrasound Mini Probe in Pre-Operative TN Staging of Colorectal Cancer

目的:探讨高频微探头超声内镜(EUS)检查在结直肠癌TN分期中的价值。方法:145例结直肠癌患者术前采用高频微探头EUS检查进行TN分期,并与术中探查和术后病理检查结果进行比较。结果:结直肠癌患者术前高频微探头EUS检查的T、N分期与术后病理分期符合率分别为84.83%和70.34%,其中T1、T2、T3、T4期的符合率分别为88.89%、85.71%、84.27%和80.00%。对有无淋巴结转移的诊断符合率较高,分别为98.41%(N+)、92.68%(NO)。N1、N2分期的符合率分别为76.92%和16.22%。结论:高频微探头EUS检查能较准确地判断结直肠癌的浸润深度(T分期),尤其适用于早期结直肠癌和癌性狭窄患者的术前分期;对有无淋巴结转移判断较准确,对N分期,尤其N2分期准确性有待提高。

Objective：To evaluate the value of high frequency endoscopy ultrasound（EUS） mini probe in the pre-operative TN staging of colorectal cancer.Methods：Colorectal cancers proved by colonoscopies and biopsies in 145 patients were preoperatively evaluated with high frequency endoscopic ultrasound mini probes to determine the depth of tumor invasion（T） and local lymph node metastasis（N） in order to estimate the accuracy of TN staging.The accuracy of T staging and tumor-node staging of colorectal cancer by EUS with high frequency mini probe was compared with post-operative pathologic findings.Results：The concordant diagnosis rates of T and N staging by endoscopic ultrasonography with high frequency mini probe and pathological findings were 84.83%and 70.34%,respectively.The concordance rates of T1,T2,T3 and T4 staging were 88.89%,85.71%, 4.27%and 80.00%,respectively.The concordance rates of EUS with high frequency mini probe in determining the stage lymph node metastasis（LNM） were 98.41%（LNM positive） and 92.68%（LNM negative）;N1 and N2 staging were 76.92% and 16.22%,respectively.Conclusions：High frequency endoscopic ultrasound mini probe in the preoperative T staging for patients with colorectal cancer was relatively high,especially for early stage colorectal cancer and those with tumor stenosis;but its accuracy in determining the N2 staging needs to be modified.