CT仿真内镜对低位直肠癌手术治疗策略的影响

Impact of CT virtual endoscopy on the strategy of low rectal cancer surgery

目的探讨CT仿真内镜在低位直肠癌手术治疗策略中的价值。方法收集济宁市第一人民医院胃肠外科2008年8月1日-2011年3月1日收治的低位直肠癌57例患者的病例资料，术前行直肠CT仿真内镜检查，详细记录患者直肠周围组织浸润和淋巴结转移的情况；术后患者常规进行病理检查，比较两者结果的差异。并且比较术前直肠肛诊和直肠CT仿真内镜测量的肿瘤距离肛缘的距离。结果术前直肠CT仿真内镜检查与术后石蜡病理检查对直肠周围淋巴结转移的判断经四格表X。检验，差异无统计学意义（X^2=2．5，P〉0．05），其对直肠周围淋巴结转移预测的敏感性达66．7％，特异性93．9％。术前直肠CT仿真内镜预测直肠周围组织浸润和术后病理检查结果经四格表X^2检验，差异具有统计学意义（X^2=4．44，P〈0．05），其对直肠癌周围组织浸润判断的敏感性达27．78％，特异性42．86％。直肠肛诊和直肠CT仿真内镜对肿瘤距离肛缘的判断差异无统计学意义（P〉0．05）。结论CT仿真内镜在术前评估低位直肠癌手术治疗策略有较大的意义，应进一步加强研究。

Objective To explore the value of CT virtual endoscopy in the treatment strategies in low rectal cancer surgery. Methods Fifty-seven cases of rectal cancer in Jining First Hospital were collected, preoperative rectum CT virtual endoscopy, detailed records of patients with rectal invasion and the circum- stances surrounding lymph nodes were investigated. Differences were compared in patients after routine path- ological examination. And the distance of the tumor from the anal margin was compared with the preoperative rectum on rectal examination and rectal CT virtual endoscopy. Results Preoperative rectum CT virtual en- doscopy had no significant difference in evaluation of metastases of the surrounding lymph nodes. Compared with postoperative pathological examination（ X^2= 2.5, P 〉 0.05 ） , while had significant difference in evalua- tion in perirectal infiltration（ X^2 = 4.44, P 〈 0.05 ）. Rectal examination and rectum CT virtual endoscopy had no significant difference judgement of the tumor from the anal margin （ P 〉 0.05 ）. Conclusions CT virtual endoscopy has a great significance in the preoperative evaluation of rectal cancer surgical treatment strategies, which should be further studied.