超声内镜与CT对消化道恶性肿瘤术前分期的价值比较

A comparison of computed tomography and endoscopic ultrasonography in the preoperative staging of gastrointestinal cancers

目的 探讨超声内镜与CT在消化道恶性肿瘤术前分期中的价值。方法 43例临床确诊为消化道恶性肿瘤的患者 ,术前分别行超声内镜和CT分期 ,并与术后病理结果对照。结果 浸润层次 (T分期 )方面 ,超声内镜准确性为 88.4% (38/43) ,CT为 5 5 .8% (2 4/43)。过低分期超声内镜、CT分别为 4.6 %和 30 .2 % ,过高分期分别为 7.0 %和 14 .0 %。超声内镜、CT术前T分期与术后病理分期准确率比较 ,经 χ2 检验 ,P =0 .0 0 1,超声内镜、CT对淋巴结转移癌的检测结果分别为 :敏感性 89%vs 6 6 % ,特异性 71%vs 6 4% ,阳性预测值86 %vs 79% ,阴性预测值 77%vs 47%。结论 超声内镜对消化道恶性肿瘤的浸润层次与淋巴结转移的诊断都比CT准确 ,而且操作简便、安全、价格低廉 ,有重要的临床价值。结合CT检查有助于对患者疾病整体情况的认识和对治疗方案的选择。

Objective To investigate the clinical value of endoscopic ultrasonography (EUS) and CT in preoperative staging of gastrointestinal cancers.Methods Forty three cases of gastrointestinal cancers were scanned by EUS and CT,then staged and compared with the pathological staging.Results For invasive layers (T stage), the accuracy of EUS was 88.4% (38/43) , and that of CT was 55.8% (24/43). For understage the accuracy of EUS and CT were 4.6% and 30.2% pespectively, whereas for overstage were 7% and 14% pespectively.For lymph nodes (N stage ), the sensitivity,spectivity,positive predicting value,negative predicting value for EUS and CT each were 89% vs 66%,71% vs 64%,86% vs 79%,and 77% vs 47% respectively.Conclusions EUS compared with CT was superior in regional preoperative staging for gastrointestinal cancer, including invasive layer and lymph node. EUS was a simple, safe,low cost and reliable method. Combined with CT scanning, it was helpful to assess an overall status of a patient and of importance to select a therapy.