胃窗超声造影对溃疡型胃癌T分期判断的影响因素

Impact factors investigation in oral ultrasonic contrast agent on diagnosis of ulcerative type gastric neoplasms on T staging

目的 探讨影响胃窗超声造影检查对溃疡型胃癌T分期准确性的因素.方法 收集术后经病理确诊且术前做过胃窗超声造影检查的82例溃疡型胃癌患者资料,并与术后病理结果进行比较,分析病变部位、大小对溃疡型胃癌T分期的影响.结果 胃窗超声造影检查对胃小弯病变、胃窦病变T分期的准确率分别为91.3 ％（21/23） 、85.7 ％（24/28）,两者与病理结果一致性较好（Kappa值分别为0.763、0.68,P＜ 0.05）,对贲门位置病变的T分期准确率为68.0％（17/25）,与术后病理结果比较一致性一般（Kappa值为0.446,P＜0.05）;因胃大弯病变资料较少,对T分期准确性的影响有待进一步研究;对癌灶最大径≤5.0 cm病灶组T分期的准确率为92.3％（36/39）,对＞5.0 cm病灶组T分期的准确率为72.1％（31/43）,两者比较差异有统计学意义（x2=5.591,P＜ 0.05）.结论 胃窗超声造影对胃小弯和胃窦溃疡性胃癌以及对≤5.0 cm的溃疡型病灶T分期诊断准确性较高.

Objective To explore the factors affecting diagnosis accuracy on T stage of oral ultrasonic contrast agent examination on ulcerative gastric neoplasms.Methods Data from 82 patients were analyzed who were pathologically diagnosed as ulcerative gastric neoplasms ultrasounds data of oral ultrasonic contrast agent before surgery were compared to postoperative pathology,analysis had been done on influence of the lesion site,size of the T staging on ulcerative gastric neoplasms.Results The diagnosis accuracy rate of T stage on lesser curvature of stomach and gastric antrum were 91.3 % （21/23） and 85.7 % （24/28）,compared with the pathological results were in good concordancy （Kappa =0.763,0.68,P 〈 0.05）.The accuracy rate of T stage on cardiac lesions was 68.0 % （17/25）,compared with the pathological results consistency in general （Kappa =0.446,P 〈 0.05）.Further research on the effects of T stage accuracy would be necessary.The accuracy rate ofT staging on tumor size ≤ 5.0 cm group and 〉 5.0 cm were 92.3 % （36/39） and 72.1% （31/43）,the difference was significant in two groups （x2 =5.591,P 〈 0.05）.Conclusion Oral ultrasonic contrast agent application is more accurate on lesser curvature of stomach,gastric antrum and lesions size ≤ 5.0 cm.