超声内镜在大肠癌诊断及微创治疗中的应用

Study of endoscopic ultrasonography in the diagnosis and endoscopic therapy of colorectal cancer

目的探讨超声内镜(endoscopic ultrasonography,EUS)在大肠癌TNM分期及微创治疗中的应用价值。方法对23例经内镜或腹腔镜手术切除的大肠癌患者术前行EUS检查,术后常规病理检查,以病理诊断为金标准对EUS进行评价。结果 EUS对大肠癌T分期的总准确率为80.6%,其中对T1期的准确率为100.0%,T2期的准确率为68.8%,T3期的准确率为90.0%;以N0为N-组,N1+N2为N+组,对N分期的准确率为77.4%,敏感度和特异度分别为58.3%和89.5%,阳性预测值为77.8%,阴性预测值为77.3%,Youden指数为0.478。结论 EUS对大肠癌T1、T3和N分期的判断有较高的准确率,术前EUS检查可为大肠癌治疗方式的选择提供指导。

Objective To evaluate the value of endoscopic ultrasonography（EUS） in the diagnosis and en-doscopic therapy of colorectal cancer.Methods A total of 23 cases were treated by different endoscopic theraputic techniques according to the results of EUS.The specimens were routinely diagnosed by pathology.The sensitivity, specificity, positive predictive value of EUS were evaluated according to pathological diagnosis as the gold standard. Results The total accuracy of T-staging by EUS on colorectal cancer was 80.6%, among them, the accuracy of T1-staging by EUS on colorectal cancer was 100.0%, accuracy of T2-staging by EUS on colorectal cancer was 68.8%, and accuracy of T3-staging by EUS on colorectal cancer was 90.0%, respectively.The accuracy of N-staging by EUS on colorectal cancer was 77.4%.The sensitivity and specificity of N-staging by EUS on colorectal cancer were 58.3%and 89.5%, respectively.The positive predictive value, negative predictive value and Youden index of N-staging by EUS on colorectal cancer were 77.8%, 77.3%, and 0.478, respectively.Conclusion These results sug-gest that EUS have higher accuracy judgment on staging of colorectal cancer T1, T3, and N-staging by EUS checks provide guidance for selection of the treatment of colorectal cancer.