小探头超声内镜用于早期胃癌分期判断的影响因素

Affecting factors of miniprobe endoscopic ultrasonography in staging of early gastric cancer

目的:探讨小探头超声内镜(EUS)在早期胃癌分期中的评估价值及影响因素。方法:选取延安大学附属医院2016年2月~2018年2月收治的经病理证实的早期胃癌患者100例,所有患者术前均进行EUS检查,明确胃癌精确分期,并与病理结果进行比较,计算EUS评价的准确率。根据EUS检查结果,将其分成准确组和不准确组,比较两组临床特征,包括性别、年龄、体质量指数、肿瘤直径、分化类型、肿瘤部位、浸润深度、大体分型、淋巴管浸润。利用Logistic回归模型分析影响EUS评估早期胃癌分期的因素。结果:小探头超声评价早期胃癌T1a期、T1b期、T2期的准确率分别为88.57%、82.61%、78.95%,总准确率为84.00%。准确组的肿瘤直径≥2 cm、肿瘤位于胃上段、隆起型占比分别为59.52%、17.86%、11.90%,低于不准确组的87.50%、50.00%、43.75%,差异有统计学意义(P<0.05)。Logistic回归分析提示肿瘤直径(≥2 cm)、肿瘤部位(胃上段)、大体分型(隆起型)是EUS评价早期胃癌分期准确性的危险因素(P<0.05)。结论:小探头超声内镜评价早期胃癌分期的准确率较高,但其准确性受肿瘤直径、肿瘤部位及大体分型的影响。

Objective To explore the value and affecting factors of miniprobe endoscopic ultrasonography(EUS)in the staging of early gastric cancer.Methods Atotal of 100 patients with pathologically-proved early gastric cancer who were admitted toYan'an University Affiliated Hospital between February 2016 and February 2018 were enrolled in the study.All patients were examined by EUS before operation to determine the exact staging of gastric cancer,and the obtained results were compared with pathological results for evaluating the accuracy rate of EUS.According to the results of EUS examination,the patients were divided into accurate group and inaccurate group.The clinical features of two groups were compared,and the clinical features includes gender,age,body mass index,tumor diameter,differentiation type,tumor location,depth of invasion,gross classification and lymphatic vessel invasion.Logistic regression model was used to analyze the factors affecting EUS assessment of the staging of early gastric cancer.Results The accuracy rate of EUS in the staging of early gastric cancer at T1a,T1b and T2 stages was 88.57%,82.61%and 78.95%,respectively,and the total accuracy rate was 84.00%.In accurate group,the percentages of tumors with a diameter≥2 cm,tumors locating at the upper gastric segment and protruded type were 59.52%,17.86%and 11.90%,respectively,which were lower than 87.50%,50.00%and 43.75%in inaccurate group(P<0.05).The results of Logistic regression analysis indicated that tumor diameter(≥2 cm),tumor location(upper gastric segment)and gross classification(protruded type)were the risk factors for EUS in the staging of early gastric cancer(P<0.05).Conclusion EUS in the staging of early gastric cancer has a high accuracy rate,but the accuracy is affected by the diameter,location and gross classification of the tumor.