超声胃镜在胃癌术前检查中的应用价值

Application value of endoscopic ultrasonography in the detection before the operation of gastric cancer

目的探讨术前超声胃镜在判断胃癌临床病理特征中的应用价值。方法回顾性分析上海市静安区中心医院2008年1月～2013年1月125例术前行超声胃镜检查的胃癌患者的临床资料，将超声胃镜检查结果与术后病理结果做对比分析。结果超声胃镜检查与术后病理在判断肿瘤侵袭深度上的吻合率是55．2％；单因素分析显示，当胃癌病灶直径〉3cm或大体形态为凹陷型，超声胃镜对肿瘤侵润深度的判断准确率下降：多因素分析表明，胃癌位于胃底部或大体形态表现为凹陷型可能是影响EUS诊断吻合率的独立因素，其次肿瘤浸润越深，超声胃镜检查与术后病理结果吻合度越高。结论超声内镜检查对胃癌的术前T分期有较高的应用价值，但超声内镜检查结果提示病灶位于胃底部、病灶直径〉3cm、大体形态是凹陷型时，与术后病理结果吻合率不高。

Objective To explore the clinical Value of endoscopic uhrasonography （EUS） in judging pathological fea- tures of gastric cancer. Methods The clinical data of 125 patients with gastric cancer who underwent EUS before opera- tion in the Central Hospital of Jing＇an District in Shanghai City from January 2008 to January 2013 was analyzed retro- spectively. The preoperative EUS results were compared with the pathological findings. Results The overall proportion of coincidence for depth of invasion between EUS and pathologic results was 55.2%. Single factor analysis showed that the rate of corrected prediction of EUS for tumor depth significantly decreased for the lesions more than 3 cm in diam- eter and those with a depressed morphology. In multivariate analysis, the depressed type and upper third of the stomach was the significantly independent factors influencing the inaccurate prediction of EUS for tumor depth, secondly, if tu- mor invade deeper, better diagnosis can be made by EUS. Conclusion The clinical value of EUS in the preoperative staging of early gastric cancer is relatively high. But the possibility of discordance with pathologic results should be considered for the lesions located in the upper third of the stomach, lesions more than 3 cm in diameter and with a de- pressed morphology.