胃肠超声造影在胃癌原发灶诊断和分期评估中的应用价值

Application value of gastrointestinal contrast-enhanced ultrasound in the diagnosis and staging evaluation of primary gastric cancer

目的探讨胃肠超声造影(CEUS)在胃癌原发灶诊断和分期评估中的应用价值。方法选取170例经胃镜检查疑似胃癌的患者,采用增强CT和CEUS检查判断患者的肿瘤类型和分期,以手术病理结果为金标准,比较两种检查方法诊断胃癌的准确度、灵敏度、特异度,并比较两种检查方法评价胃癌T分期的符合率。结果经病理学诊断,170例患者中,良性肿瘤29例,胃癌141例。CEUS诊断胃癌的准确度、灵敏度、特异度分别为94.71%、96.45%、86.21%,分别高于增强CT诊断的68.24%、71.63%、51.72%,差异均统计学意义(P﹤0.05)。CEUS评价胃癌T分期的符合率为92.91%,明显高于增强CT的43.26%,差异有统计学意义(P﹤0.05)。结论应用胃肠CEUS技术可增强临床对胃癌原发灶诊断和分期的准确度,清晰地呈现原发灶侵袭区,该技术的安全性和经济性均较高,可为手术方案的设计提供依据。

Objective To investigate the application value of gastrointestinal contrast-enhanced ultrasound(CEUS)in the diagnosis and staging evaluation of primary gastric cancer.Method 170 patients with suspected gastric cancer examined by gastroscopy were selected.Enhanced CT and CEUS were used to determine the tumor type and stage of the patients.Surgical and pathological examination was used as the diagnostic gold standard to compare the accuracy,sensitivity and specificity of the two methods in the diagnosis of primary gastric cancer,and the coincidence rate of two methods in evaluating T staging of gastric cancer was also compared.Result According to pathological diagnosis,29 cases of benign tumor and 141 cases of gastric cancer were among 170 patients.The accuracy,sensitivity and specificity of CEUS in the diagnosis of gastric cancer were 94.71%,96.45%and 86.21%,respectively,which were higher than those of enhanced CT diagnosis(68.24%,71.63%,51.72%),and the differences were statistically significant(P<0.05).The coincidence rate of CEUS in evaluating T staging of gastric cancer was 92.91%,which was significantly higher than 43.26%of the enhanced CT,the difference was statistically significant(P<0.05).Conclusion The gastrointestinal CEUS can enhance the accuracy of diagnosis and staging of primary gastric cancer,and can clearly present the invasion area of primary gastric cancer,with high security and economy,and can provide basis for the design of surgery plan.