水囊扩张法3D经直肠腔内超声在低位直肠癌术前分期中的应用

The preoperative value of 3D endorectal ultrasonography with water balloon dilatation in low rectal cancer

目的评价水囊扩张法3D经直肠腔内超声(ERUS)检查在低位直肠癌术前分期中的灵敏度和特异度。方法采用水囊扩张法对海军军医大学附属长海医院收治的72例低位直肠癌患者行术前腔内超声检查,进行术前T分期,并与手术后病理T分期进行比较,分析超声术前分期的灵敏度、特异度、过深分期和过浅分期百分比。结果共72例患者入组,其中超声T1期直肠癌16例,T2期直肠癌23例,T3期直肠癌25例,T4期直肠癌8例。术前腔内超声诊断早期直肠癌T1、T2、T3、T4期诊断灵敏度和特异度分别为93.3%和96.5%,87.0%和93.9%,84.0%和91.5%,71.4%和95.4%。过深分期百分比为5.6%,过浅分期百分比为11.1%。结论水囊扩张法3D经直肠腔内超声检查对低位直肠癌术前分期和手术治疗具有重要的指导意义。

Objective To evaluate the sensitivity and specificity of 3D endorectal ultrasonography (ERUS) with water balloon dilatation in preoperative staging of low rectal cancer. Methods Seventy-two cases of low rectal cancer treated in the Affiliated Changhai Hospital of Naval Military Medical University were examined by intraoperative ultrasonography before operation. Preoperative T staging was performed. The sensitivity and specificity of preoperative ultrasound T staging was compared to the pathological T staging.The degrees of overly deep and overly shallow stage were assessed. Results A total of 72 patients were enrolled in the study, including 16 cases of T1 rectal cancer, 23 cases of T2 rectal cancer, 25 cases of T3 rectal cancer, and 8 cases of T4 rectal cancer. The preoperative diagnostic sensitivity and specificity of ERUS in T1, T2, T3 and T4 rectal cancer were 93.3% and 96.5%, 87.0%and 93.9%, 84.0% and 91.5%, 71.4% and 95.4%, respectively. The percentage of overly deep stage was 5.6%, and the percentage of overly shallow stage was 11.1%. Conclusion 3D endorectal ultrasonography with water balloon dilatation has important guiding significance for the preoperative staging and surgical treatment of low rectal cancer.