超声内镜对胃癌术前TN分期的诊断价值

Clinical application of endoscopic ultrasonography in the preoperative TN staging of gastric cancer

目的:评估超声内镜在胃癌术前TN分期的正确性,提高超声内镜诊断水平。方法:133例经胃镜及病理证实的胃癌患者于术前进行超声内镜检查和TN分期,并与术后组织病理分期比较。结果:超声内镜对胃癌术前T分期判断的总体准确率为81.20%,其中对T1和T4正确率较高,分别为91.67%和85.0%,而T2和T3的正确率较低,分别为74.29%和70.0%。在T分期中存在着分期过深或过浅的现象,8例分期过深,17例分期过浅,T1和T4正确率较高,而T2和T3正确率稍低。超声内镜胃癌术前分期与术后病理分期呈高度一致性(P<0.01)。N分期判断的总体准确率78.95%,淋巴结阳性和阴性的正确率分别为66.10%和89.19%,与术后病理分期差异有统计学意义(P<0.05)。结论:超声内镜能较准确地判断胃癌TN分期,可为医生制订合理的治疗方案提供依据。

Objective： To evaluate the value of endoscopic ultrasonography（ EUS） in the preoperative TN staging of gastric cancer,and to improve its diagnostic level. Methods： The preoperative TN staging of gastric cancer diagnosed by pathology in 133 patients were identified by EUS,which was compared with the postoperative histopathological stage. Results： The overall accuracy rate of preoperative T staging of gastric cancer detected by EUS was 81. 20%. The accuracy of T1 and T4 were high,whose were 91. 67% and 85. 0%,the accuracy of T2 and T3 were low,whose were 74. 29% and 70. 0%,respectively. There were too deep or too shallow phenomenon in the T staging,too deep in 8 cases and too shallow in 17 cases were found. The preoperative staging of gastric cancer detected by EUS was highly consistent with the postoperatively pathological staging（ P〈0. 01）. The overall accuracy rate of N staging identified by EUS was78. 95%,the accuracy rate of positive and negative lymph node were 66. 10% and 89. 19%,respectively,the differences of whose compared with the postoperatively pathological staging were statistically significant（ P〈0. 05）. Conclusions： Endoscopic ultrasonography can accurately identified the TN staging of gastric cancer,which can provide the basis in formulating the reasonable treatment.