ARFI与口服胃窗超声造影联合判定进展期胃癌病理分化程度

目的探讨声辐射力脉冲成像（ARFI）与口服胃窗超声造影联合判定进展期胃癌病理分化程度的价值。方法选取2015年2．8至2017年11月期间在浙江省立同德医院治疗并经术后病理证实的56例进展期胃癌患者进行研究。根据不同病理分化程度划分为：分化组（26例）及未分化组（30例），所有患者均于术前1周进行口服胃窗超声造影及ARFI检查，测量并记录肿瘤的最大径线及ARFI值，并与术后痛理结果进行比较分析。结果未分化组的最大径线明显大于分化组，差异具有统计学意义（P〈0．05）；未分化组的ARFI值明显高于分化组，差异具有统计学意义（P〈0．05）；ROC曲线分析显示，以ARFI值判定未分化进展期胃癌，曲线下面积为0．861，95％置信区间为0．768～0．954，最佳临界值为4．27m／s，灵敏度为72．00％，特异度为83．90％。结论ARFI具有无创、便捷等优点，有助于客观准确地评估进展期胃癌的病理分化程度．具有一定临床价值。

Objective To investigate the diagnostic value of oral contrast ultrasonography （ OCUS ） and acoustic radiation force Imaging （ ARFI ） in the pathological differentiation of advanced gastric cancer. Methods 56 cases of patients with gastric cancer which were confirmed by pathology in Tongde Hospital of Zhejiang Province from February 2015 to November 2017 were selected. According to the different pathological differentiation, patients were divided into： the differentiation group （26 cases ） and undifferentiated group （30 cases ） . 1 week before surgery, all patients had OCUS and AIkFI examination, and the maximum diameter and ARFI value of tumor were measured and recorded, and the results were compared with pathological results. Results The maximum diameter of undifferentiated group was significantly greater than that of differentiation group, and the difference was statistically significant （ P〈0.05 ） ; ARFI value of undifferentiated group was significantly higher than that of differentiation group, and the difference was statistically significant （ P〈0.05 ） ; l？,OC curve showed the AtkFI value determine the undifferentiated advanced gastric cancer, and the area under curve was 0.861; 95% confidence interval was 0.768～0.954; cut-off value was 4.27m/s; sensitivity was 72.00%, and specificity was 83.90%. Conclusion ARFI has the advantages of non-invasive, convenient and so on. It is helpful for the objective and accurate evaluation of the pathological differentiation of advanced gastric cancer, which has certain clinical value.