超声内镜联合增强CT对胰腺癌临床分期的诊断价值

Diagnostic value of endoscopic ultrasonography combined with CT with contrast in clinical staging of pancreatic cancer

目的探讨超声内镜(EUS)联合增强计算机断层扫描(CT)对胰腺癌临床分期的诊断价值。方法抽取2019年3月至2021年2月河南大学第一附属医院收治的疑似胰腺癌患者80例,均行EUS和增强CT检查,以病理结果为金标准,统计EUS、增强CT及二者联合的诊断结果和诊断效能,比较不同检查方式对胰腺癌T分期的诊断准确率。结果80例疑似胰腺癌患者经病理检查确诊阳性71例,阴性9例;增强CT诊断出真阳性53例,真阴性6例;EUS诊断出真阳性56例,真阴性7例;增强CT与EUS联合诊断出真阳性69例,真阴性8例。增强CT与EUS联合诊断的灵敏度[97.18%(69/71)、准确度96.25%(77/80)]高于增强CT[74.65%(53/71)、73.75%(59/80)]和EUS[78.87%(56/71)、78.75%(63/80)],漏诊率[2.82%(2/71)]低于增强CT[25.35%(18/71)]和EUS[21.13%(15/71)],P<0.05。增强CT与EUS联合诊断T2、T4分期的准确率[92.86%(13/14)、100.00%(11/11)]高于增强CT[57.14%(8/14)、63.64%(7/11)],诊断T3分期的准确率[100.00%(17/17)]高于EUS[76.47%(13/17)],P<0.05。结论EUS联合增强CT可提升胰腺癌诊断的灵敏度和准确度,减少漏诊的发生,且有利于准确评估胰腺癌临床分期,临床诊断价值显著。

Objective To investigate the diagnostic value of endoscopic ultrasonography(EUS)combined with computed tomography(CT)with contrast in clinical staging of pancreatic cancer.Methods A total of 80 patients with suspected pancreatic cancer admitted to the First Affiliated Hospital of Henan University from March 2019 to February 2021 were selected,and the patients underwent EUS and CT with contrast examinations.Taking pathological results as the gold standard,the diagnostic results and diagnostic efficacy of EUS,CT with contrast and combination of them were calculated.The diagnostic accuracy of different examination for pancreatic cancer T staging were compared.Results Of the 80 patients with suspected pancreatic cancer,71 cases were positive,and 9 cases were negative.Among them,53 cases were true positive,and 6 cases were true negative diagnosed by CT with contrast;56 true positive cases,and 7 true negative cases were diagnosed by EUS;69 true positive cases and 8 true negative cases were diagnosed by CT with contrast combined with EUS.The diagnostic sensitivity and accuracy of CT with contrast combined with EUS(97.18%,69/71;96.25%,77/80)were higher than those of CT with contrast(74.65%,53/71;73.75%,59/80)and EUS(78.87%,56/71;78.75%,63/80),while the missed diagnosis rate of CT with contrast combined with EUS(2.82%,2/71)was lower than that of CT with contrast(25.35%,18/71)and EUS(21.13%,15/71),P<0.05.The accuracy rate of CT with contrast combined with EUS in diagnosing T2 stage and T4 stage(92.86%,13/14;100.00%,11/11)were higher than those of CT with contrast(57.14%,8/14;63.64%,7/11),while the diagnostic accuracy of CT with contrast combined with EUS in diagnosing T3 stage(100.00%,17/17)was higher than that of EUS(76.47%,13/17),P<0.05.Conclusions EUS combined with CT with contrast can improve the sensitivity and accuracy in diagnosing pancreatic cancer,reduce the occurrence of missed diagnosis,which is conducive to accurately assessing the clinical staging of pancreatic cancer,with significant clinical diagnostic value.