直肠腔内超声检查在直肠癌新辅助放化疗后术前评估中的应用价值

Application Value of Endorectal Ultrasonography in Preoperative Evaluation Following Neoadjuvant Radio-Chemotherapy for Rectal Cancer

目的:探讨直肠腔内超声(ERUS)检查在直肠癌新辅助放化疗后术前评估中的应用价值。方法:选择2020年9月至2021年9月拟于我院接受新辅助放化疗后行直肠癌根治术治疗的80例患者为研究对象,患者新辅助放化疗前均经肠镜检查确诊直肠癌,新辅助化疗后术前均接受ERUS检查,其中50例新辅助放化疗前后均接受ERUS检查(A组),30例仅于新辅助放化疗后术前接受ERUS检查(B组)。比较A组患者新辅助放化疗前后肿瘤至肛缘的距离、肿瘤大小(累及肠管的长度及厚度);并以术后病理学T分期诊断结果为标准,评价ERUS诊断直肠癌T分期的准确性。结果:A组患者新辅助放化疗后肿瘤至肛缘的距离明显增加,肿瘤累及肠管的长度及肿瘤的厚度均明显减小,P <0.05。ERUS检查诊断直肠癌T分期的准确性分别为uT0期82.50%(66/80),uT1期96.25%(77/80),uT2期83.75%(67/80),uT3期73.75%(59/80),uT4期98.75%(79/80)。结论:通过ERUS检查不仅可准确获得肿瘤至肛缘的距离、肿瘤累及肠管的长度及肿瘤的厚度等信息,而且对于直肠癌新辅助放化疗后术前T分期评估具有一定价值。

Objective To investigate the application value of endorectal ultrasonography(ERUS) in preoperative evaluation following neoadjuvant radio-chemotherapy(NRCT) for rectal cancer.Methods Enrolled 80 rectal cancer patients to be subject to radical surgery after NRCT in author’s hospital(2020-09—2021-09) into this study:before NRCT the 80 patients were confirmed as rectal cancer by enteroscopy,after NRCT but before surgery received ERUS inspection,in whom 50 cases before and after NRCT all received ERUS inspections as group A,rest 30 cases,only between after NRCT and before surgery received ERUS inspection,as group B;Then,compared the patients distance of neoplasms from ano-edge,and neoplasm size(involved bowel canal’s length and thickness);then,took postoperative pathological exam.results of T stage as standard to evaluate the accuracy on ERUS diagnosing T stage in group A between before and after NRCT.Results After NRCT in group A the patients’ distance,as well as the involved length and thickness were significantly increased,as well as reduced(P<0.05).The accuratcy of ERUS diagnosing T stage of rectal cancer was respectivley as:uT0 stage,82.50%(66/80),uTl stage,96.25 %(77/80);uT2 stage,83.75%(67/80);uT3 stage,73.75%(59/80),and uT4 stage,98.75%(79/80).Conclusion ERUS inspection not only can accurately obtain the distance of neoplams from ano-edge,the involved bowel-canal’s length and thickness of neoplasms,etc data,but has the certain value in preoperative evaluation of T stage of neoplasms between after NRCT and before surgery.