直肠腔内超声与MRI对直肠癌术前分期评价

The Evaluation of ERUS and MRI in Preoperative Staging of Rectal Cancer

目的评估直肠腔内超声(ERUS)、MRI对直肠癌患者术前分期与病理对照的准确率。方法回顾性分析2015年1月至12月于本院行ERUS检查和盆腔MRI检查的72例直肠癌患者资料,根据术后病理结果,按照美国癌症联合委员会(AJCC)直肠癌分期指南行T、N分期,将ERUS和MRI对直肠癌局部T、N分期的准确率与病理结果对照,并行一致性评价。结果总共纳入72例直肠癌患者,与术后病理结果对照,经ERUS、MRI的T分期总准确率分别为81.94%(59/72)、66.67%(48/72)(Kappa值分别为0.745、0.524,P均<0.001),经ERUS、MRI的N分期总准确率分别为65.28%(47/72)、77.78%(56/72)(Kappa值分别为0.350、0.599,P均<0.001)。结论与病理结果对照,ERUS对直肠癌术前T分期的一致性较好,而MRI对N分期的一致性较好,ERUS与MRI是评估直肠癌术前分期有效的影像学检查方法。

Objective To evaluate the efficacy of Endorectal ultrasound（ERUS） compared to magnetic resonance imaging（MRI） in the preoperative staging of rectal cancer patients with pathological examinations as a control. Methods From January to December,2015, a total of 72 patients with confirmed pathological examinations of rectal cancer had undergone endorectal ultrasound and magnetic resonance imaging examinations, the preoperative T and N staging are dependent on the AJCC staging cancer manual（ American Joint Committee On Cancer）. The results were compared with those of postoperative pathological staging. Results the accuracy of ERUS and MRI for T staging was 81.94% （59/72） ,66.67% （ 48/72 ） respectively （ Kappa consistencyexamination with the pathologicalresuhs analysis, Kappa = 0. 745,0. 524, P 〈 0.001 ）, for N staging was 65.28% （47/72） ,77.78% （56/72） respectively （Kappa = 0. 350,0. 599, P 〈 0. 001 ）. Conclusion Compared to the postoperative pathological staging, ERUS has a better consistency for T staging with pathological results, while MRI has better consistency for N staging. ERUS and MRI are two useful examination methods in preoperative staging of rectal cancer.