经直肠双平面超声判断直肠癌术前T分期

Preoperative judging of T-staging of rectal cancer by transrectal biplane ultrasound

目的探讨经直肠双平面超声判断直肠癌T分期的准确性。方法197例经肠镜活检病理证实、无严重肠梗阻的中低位直肠癌患者，应用经直肠双平面超声观察肠壁回声改变、癌肿浸润肠壁深度及有无前列腺、精囊腺或宫颈、阴道等侵犯，并进行术前分期，将检查结果与术后病理对照，Kappa检验评估两者结果的一致性。结果经直肠双平面超声判断直肠癌T分期的总正确率为83．8％，T1～T4诊断敏感度分别为77．8％、73．1％、89．3％和94．4％，特异度分别为97．3％、93．1％、85．1％、97．8％。k值为0．732，超声分期与病理分期的结果高度一致（Pd0．05）。结论经直肠双平面超声对直肠癌术前T分期有重要价值，有助于治疗方案的制定。

Objective To explore the accuracy of judging the T-staging of rectal cancer by biplane transrectal ultrasound. Methods Pathological enteroscopic biopsy was carried out for 197 cases of rectal cancer. Cases of middle and lower rectal cancer without serious obstruction were examined by means of transreetal biplane ultrasound through which to observe the changes of the echoes and to detect the depth of the infiltration in the intestinal walls and the presence of invasions in prostate glands, seminal in male or vesicles,uterine cervix in female. On the basis of the findings, the preoperative tumor staging was made. Postoperatively,the ultrasound results were compared with the pathological examination. Their consistency was evaluated by using Kappa test. Results Transrectal biplane ultrasound examination showed the total accuracy rate in T-staging of rectal cancer was as high as 83.8% with the diagnostic sensitivity rate for T1 to T4 as 77.8%, 73.1%, 89.3% and 94.4%, while its diagnostic specificity rate degree was 97.3%, 93.1 % ,85.1% ,97. 8% respectively. The k-value was 0. 732 which suggested that the ultrasound staging was highly consistent with the pathological staging（ P 〈0.05）. Conclusions Transrectal biplane ultrasound has a great value in the preoperative T-staging of rectal cancer and is helpful in the planning of treatment.