关于结肠增强CT与结肠镜对左半结肠癌定位准确性的对比分析

Contrastive analysis of the accuracy of colon enhanced CT and colonoscopy in the localization of left colon cancer

目的:对比分析增强CT扫描与结肠镜对定位左半结肠癌(LCC)的准确性。方法:选取2019年1-9月行腹腔镜下左侧结肠癌根治术患者24例,分别通过增强CT扫描和结肠镜检查计算肿瘤距肛门边缘的距离(TDAV),并将其与术中测量所得的TDAV进行比较。统计分析三种测量方法所得TDAV的均数,比较结肠镜下测量所得TDAV与术中测量所得TDAV误差≤5 cm患者数量和增强CT扫描测量所得TDAV与术中测量所得TDAV误差≤5 cm患者数量,分析增强CT扫描与结肠镜检查及术中测量所得TDAV的统计学关系。结果:与术中测得TDAV相比,结肠镜和增强CT扫描测量所得TDAV值均高约4 cm以上。随着术中测得TDAV值的增加,两种术前检查测得TDAV值与之差异越来越大。术前结肠镜检查测得TDAV值与术中测得TDAV值相差≤5 cm的占75.0%,术前增强CT扫描测得TDAV值与术中测量所得TDAV值相差≤5 cm的占58.3%。结论:两种术前检查方法均有一定缺陷,均高估了约4 cm以上。术前检查的偏倚随着TDAV长度的增加而成比例增加,尤其距离肛门边缘越远差异越明显。

Objective:To compare the accuracy of contrast enhanced CT scan and colonoscopy in the localization of left colon cancer(LCC).Methods:From January to September 2019,24 patients who underwent laparoscopic radical resection of left colon cancer were selected.The distance from the tumor to the anal edge(TDAV)was calculated by enhanced CT scan and colonoscopy,respectively,and compared with the TDAV measured intraoperatively.The mean value of TDAV obtained by the three measurement methods was statistically analyzed,and the number of patients with TDAV error≤5 cm measured under colonoscopy and intraoperative measurement and the number of patients with TDAV error≤5 cm measured by enhanced CT scan were compared,and the statistical relationship between enhanced CT scan and colonoscopy and intraoperative measurement was analyzed.Results:Compared with intraoperative TDAV,TDAV values measured by colonoscopy and enhanced CT were overestimated by more than 4 cm.With the increase of TDAV measured intraoperatively,the difference between TDAV measured by the two preoperative examinations and TDAV measured by the two preoperative examinations became more and more significant.The difference between preoperative TDAV measured by colonoscopy and intraoperative TDAV was≤5 cm in 75.0%of patients,and the difference between preoperative TDAV measured by enhanced CT scan and intraoperative TDAV was≤5 cm in 58.3%of patients.Conclusion:Both of the two preoperative examination methods have some defects,and both overestimate by more than 4 cm.Preoperative examination bias increased proportionally with the length of TDAV,especially with the distance from the anal edge,the difference was more obvious.