超声造影参数对胃癌患者淋巴结转移的评估价值

Evaluation Value of Contrast-Enhanced Ultrasound Parameters on Lymph Node Metastasis in Patients with Gastric Cancer

目的探讨超声造影(CEUS)参数在胃癌淋巴结转移评估中的应用价值。方法选取2018年10月至2020年7月固始县中医院收治的100例胃癌患者作为研究对象。统计胃癌患者淋巴结转移情况;根据患者淋巴结转移情况分为淋巴结转移组与无转移组;设计患者基线资料调查表,比较两组患者基线资料及CEUS检查相关参数[达峰时间(TTp)、增强时间(ET)、曲线上升支斜率(WIR)],分析CEUS参数在胃癌患者淋巴结转移中的评估价值。结果淋巴结转移组患者TNM分期Ⅱ期占比高于无转移组,差异有统计学意义(P<0.05);两组间性别、年龄、体质量指数(BMI)、病程、肿瘤直径相比,差异无统计学意义(P>0.05);淋巴结转移组TTP值、ET值低于无转移组,WIR值高于无转移组,差异有统计学意义(P<0.05)。绘制ROC曲线结果显示,TTP、ET、WIR值单独及联合评估胃癌患者淋巴结转移情况的曲线下面积(AUC)均>0.7,均有一定的评估效能,以联合评估效能最好;且当各参数cut-off值分别取16.190s、11.330s、7.325时,可获取最佳评估价值。结论TTP、ET、WIR值等CEUS参数均能有效评估胃癌患者淋巴结转移情况,且TTP、ET、WIR值联合评估的效能更好。

Objective To evaluate the value of contrast-enhanced ultrasound(CEUS)parameters in the evaluation of lymph node metastasis of gastric cancer.Methods A total of 100 patients with gastric cancer treated in Gushi County Hospital of Traditional Chinese Medicine from October 2018 to July 2020 were selected as the research subjects.The lymph node metastasis of patients with gastric cancer was counted.According to the lymph node metastasis,the patients were divided into lymph node metastasis group and non metastasis group.The baseline data questionnaire of patients was designed,and the baseline data and CEUS examination related parameters[time to peak intensinty(TTp),enhanced time(ET),wash in rate(WIR)]of patients in both groups were compared.The value of CEUS parameters in the evaluation of lymph node metastasis in patients with gastric cancer was analyzed.Results The proportion of TNM stageⅡof patients in lymph node metastasis group was higher than that in non metastasis group,the difference was statistically significant(P<0.05).There were no statistical significant differences in gender,age,BMI,course of disease and tumor diameter between the two groups(P>0.05).The values of TTp and ET in lymph node metastasis group were lower than those in non metastasis group,and the value of WIR was higher than that in non metastasis group,the differences were statistically significant(P<0.05).The ROC curve was drawn,and the results showed that,the area under the curve(AUC)of TTp,ET and WIR value alone and in combination in evaluating lymph node metastasis in patients with gastric cancer were>0.7,all had certain evaluation efficiency,and the joint evaluation efficiency was the best.The best evaluation value could be obtained when the cut-off values of each parameter were 16.190 s,11.330 s and 7.325 respectively.Conclusion CEUS parameters such as TTp,ET and WIR can effectively evaluate lymph node metastasis in patients with gastric cancer,and the efficiency of joint evaluation of TTp,ET and WIR is better.