食管胃结合部腺癌65例形态超声及其分型和病理诊断

Ultrasonographic appearance and diagnosis of Adenocarcinoma of esophagogastric junction(a report of 65 cases)

目的探究体表超声诊断食管胃结合部腺癌(AEG)的分型及肿块大小的准确性。方法选取65例AEG病人,均术前行体表超声及CT检查,结合术后病理进行分析对比。结果 65例AEG病人,大体标本BorrmannⅢ型31例,占47.7%,组织学标本低分化腺癌29例,占44.6%;参照Siewert分型,体表超声和CT对AEG临床分型诊断正确率分别为90.8%、92.3%,其中Ⅰ型85.7%、92.9%,Ⅱ型91.4%、88.6%,Ⅲ型93.8%、100%,两者诊断AEG分型存在一致性,差异有统计学意义(Kappa=0.852,P<0.05);体表超声测量肿块最长径为(4.00±1.84)cm,术后病理测量肿块最长径为(4.41±2.52)cm,两者差异无统计学意义(t=-1.512,P>0.05)。结论体表超声可以作为诊断AEG分型及测量AEG肿块大小的可靠检查手段,对于指导手术以及判断预后有很大意义。

Objective To investigate the accuracy of transabdominalultrasoud （ TUS） in diagnosis of the clinical classification and tumor size of adenocarcinoma of esophagogastric junction （AEG） . Methods Totally 65 patients who received surgical resection with a preliminary diagnosis of AEG by gastroscopy biopsy from August 2015 to May 2016 were checked with TUS and CT preoperatively, and the results were compared with postoperative pathology. Results Referring to histological type and Siewert＇s classification, of all the postoperative pathological data,31 cases （47. 7% ） were Borrmann type Ⅲ ;29 cases （44. 6 % ） were poor differentiated adenocarcino- ma;TUS and CT on the accurate diagnosis in AEG＇s clinical classification were 90. 8% ,92. 3% ,respectively;among which type Ⅰ was 85. 7% ,92. 9% ;and Ⅱ was 91.4% ,88. 6% ;Ⅲ was 93. 8% , 100%. TUS and CT have consistency in diagnosis of AEG＇s clinical clas-sification, and there was no significant difference between them（P 〈0. 05）. The longest diameter of the tumor measured by TUS was （4. 00 ± 1.84） cm,and the result of postoperative pathology was （4. 41 ± 2. 52） cm, there was no significant difference between the two groups（P 〉0. 05） . Conclusions TUS is an available tool for the diagnosis of the type of AEG,andTUS can be used as a reliable means to measure the size of AEG mass. It is of great significance to guide the operation and judgethe prognosis.