胃肠超声造影联合超声内镜对老年胃癌患者T分期的价值研究

Clinical value of gastrointestinal ultrasonography combined with echoendoscope for T staging of gastric cancer in the elderly patients

目的探讨胃肠超声造影联合超声内镜在老年胃癌患者T分期中的应用价值。方法回顾性分析2016年1月-2021年12月在该院诊疗的102例老年胃癌患者的临床资料,年龄60~78岁,术前1周均行胃肠超声造影和超声内镜。观察不同检查方法术前的影像学诊断资料,以术后病理T分期作为诊断金标准,比较胃肠超声造影、超声内镜和胃肠超声造影联合超声内镜在老年胃癌患者T分期中的临床应用价值。结果胃肠超声造影对老年胃癌患者T分期总体诊断准确率为70.59%,超声内镜总体诊断准确率为73.53%,胃肠超声造影联合超声内镜总体诊断准确率为85.29%。胃肠超声造影联合超声内镜在老年胃癌患者T分期中,总体诊断准确率明显高于单独胃肠超声造影和超声内镜(P<0.05);对于T_(1)期和T_(2)期老年胃癌患者,联合检查诊断准确率略高于超声内镜,高于胃肠超声造影,但差异均无统计学意义(P>0.05);对于T_(3)期老年胃癌患者,胃肠超声造影与超声内镜诊断准确率相当,略低于联合检查,差异均无统计学意义(P>0.05);对于T4期老年胃癌患者,联合检查诊断准确率略高于胃肠超声造影(P>0.05),而明显高于超声内镜(P<0.05)。结论胃肠超声造影联合超声内镜,能明显提高老年胃癌患者T分期总体诊断准确率;对于T_(1)期和T_(2)期老年胃癌患者,可优先选择超声内镜;对于T_(3)期和T4期老年胃癌患者,可选择联合检查,以弥补单一检查的不足,从而为临床手术方案的选择,提供更精确的指导。

Objective To explore the application value of gastrointestinal ultrasonography combined with echoendoscope in the T stage of gastric cancer in the elderly patients.Methods A retrospective analysis was conducted on the clinical data of 102 elderly gastric cancer patients aged 60~78 years old from January 2016 to December 2021,and gastrointestinal ultrasonography and echoendoscope were examined one week before surgery.The clinical values of gastrointestinal ultrasonography,echoendoscope,gastrointestinal ultrasonography combined with echoendoscope in T stage of elderly patients were compared by observing the preoperative imaging diagnostic data of different examination methods,and taking postoperative pathological T staging as the gold standard for diagnosis.Results The overall diagnostic accuracy of gastrointestinal ultrasonography for T stage of elderly gastric cancer was 70.59%,the accuracy of echoendoscope diagnosis was 73.53%,and the diagnostic accuracy of gastrointestinal ultrasonography combined with echoendoscope was 85.29%.In the T stage of elderly gastric cancer,the diagnostic accuracy of gastrointestinal ultrasonography combined with echoendoscope was significantly higher than that of gastrointestinal ultrasonography and echoendoscope alone.For T_(1)and T_(2)elderly gastric cancer,the diagnostic accuracy of combined examination was higher than that of echoendoscope and higher than that of gastrointestinal ultrasonography,but there were no significant differences(P>0.05).For T_(3)elderly gastric cancer,gastrointestinal ultrasonography had the same diagnostic accuracy as echoendoscope,but was lower than that of combined examination,but there were no significant differences(P>0.05).For T4 elderly gastric cancer,the diagnostic accuracy of combined examination was higher than that of gastrointestinal ultrasonography,but there was no significant difference(P>0.05),and significantly higher than that of echoendoscope(P<0.05).Conclusion Gastrointestinal ultrasonography combined with echoendoscope significantly improve the overall diagnostic accuracy of T stage of gastric cancer in the elderly.For stage T_(1)and T_(2)elderly gastric cancer,echoendoscope can be selected;For T_(3)and T4 gastric cancer,combined examination can be selected to make up for the shortcomings of single examination and provide more accurate guidance for the selection of clinical surgical plan.