超声双重造影在不同部位胃癌术前T分期及Borrmann分型中的应用价值

Application value of double contrast-enhanced ultrasound in preoperative T-staging and Borrmann classification of gastric cancer in different sites

目的 探讨超声双重造影在不同部位胃癌术前T分期及Borrmann分型中的应用价值。方法 回顾性分析我院91例胃癌患者的术前超声双重造影检查资料,根据胃癌发生部位分为胃上、中、下部癌,应用超声双重造影对不同部位胃癌进行术前定位、T分期,对进展期胃癌进行Borrmann分型,并与病理结果对照。结果 超声双重造影术前定位胃癌的符合率为94.51%(86/91),术前诊断胃癌T分期的总体符合率为69.23%(63/91),术前诊断进展期胃癌Borrmann分型的总体符合率为85.92%(61/71)。超声双重造影术前诊断胃下部癌T分期与病理结果的一致性较好(Kappa=0.75),诊断胃上部和胃中部癌T分期与病理结果的一致性均中等(Kappa=0.49、0.67);术前诊断胃上部和胃下部进展期胃癌Borrmann分型与病理结果的一致性均较好(Kappa=0.92、0.78),诊断胃中部进展期胃癌Borrmann分型与病理结果的一致性中等(Kappa=0.68)。结论 超声双重造影对胃癌术前定位、诊断总体T分期和Borrmann分型的准确率均较高,在不同部位胃癌术前T分期和Borrmann分型诊断中存在差异,临床医师可根据需要选用此项检查。

Objective To explore the application value of double contrast-enhanced ultrasound(DCEUS)in preoperative T-staging and Borrmann classification of gastric cancer in different sites.Methods A retrospective analysis was performed on the preoperative DCEUS data of 91 patients with gastric cancer in our hospital.The gastric cancer was divided into upper gastric cancer,middle gastric cancer and lower gastric cancer according to the incidence site.Pre-operative localization,T-staging of gastric cancer and Borrmann classification of advanced gastric cancer in different sites were performed by DCEUS,the results was compared with the pathological results.Results The coincidence rate of preoperative localization of gastric cancer by DCEUS was 94.51%(86/91).The overall coincidence rates of preoperative T-staging for gastric cancer and Borrman classification for advanced gastric cancer by DCEUS were 69.23%(63/91)and 85.92%(61/71),respectively.Preoperative T-staging of lower gastric cancer diagnosed by DCEUS had high consistency with pathological results(Kappa=0.75),while the preoperative T-staging of upper gastric cancer and middle gastric cancer diagnosed by DCEUS had medium consistency with pathological results(Kappa=0.49,0.67).The preoperative Borrmann classification of upper and lower advanced gastric cancer diagnosed by DCEUS had high consistency with pathological results(Kappa=0.92,0.78),while the preoperative Borrmann classification of middle advanced gastric cancer diagnosed by DCEUS had medium consistency with pathological results(Kappa=0.68).Conclusion DCEUS has higher accuracy in the assessment of preoperative localization,overall T-staging and Borrmann classification of gastric cancer.DCEUS is different in the preoperative T-staging and Borrmann classification diagnosis of gastric cancer in different sites,clinicians can choose this examination according to their needs.