超声内镜和螺旋CT检查对胃癌术前TNM分期的比较研究  

Endoscopic Ultrasonography Versus Helical Computed Tomography for Preoperative Staging of Gastric Cancer

作　　者：何远琴[1] 王锦萍[1] 赵志清[2] 郑可国[2] 崔毅[1] 

机构地区：[1]中山大学附属第一医院消化科,广州510080 [2]中山大学附属第一医院放射科

出　　处：《中国消化内镜》2008年第7期21-24,共4页Digestive Disease and Endoscopy

摘　　要：目的前瞻性的比较超声内镜和螺旋CT检查对胃癌术前TNM分期的应用价值及探讨TNM分期标准的改变对两者准确性的影响。方法对43例经活检证实的胃癌患者术前分别行超声内镜和螺旋CT检查,确定肿瘤侵犯深度(T)、局部淋巴结转移(N)、周围及远处器官转移(M)等情况,并与术后病理检查结果对照。结果对T分期的准确率,内镜超声检查(EUS)为71.1%,螺旋CT检查(HCT)为65.8%,两者的准确率差异无统计学意义(P>0.05),对T1、T2期胃癌,EUS与HCT的准确率分别为71.4%、14.3%(P=0.05)。对N分期的准确率,以第四版TNM分期标准,EUS与HCT分别为76.3%和65.8%,以第五版TNM分期标准,EUS与HCT分别为60.5%和63.2%,两者的准确率差异均无统计学意义(P>0.05)。对M分期两者的准确率分别为30%(3/10)、80%(8/10),P<0.05.结论EUS和HCT在胃癌术前TNM分期中均有较高的准确性,对胃壁较浅层受浸润深度的判断以EUS为优,对远处转移的判断以HCT为优;TNM分期标准改变对两种方法的N分期结果均无明显影响。Objective： To compare endoscopic ultrasonography and helical computed tomography in the TNM staging of gastric cancer and to assess the impact of changes in the TNM classification on the staging accuracy of these methods. Methods： Both EUS and HCT were performed in 43 patients with gastric cancer proved by biopsy, and the results of EUS and HCT were compared prospectively with surgical pathological findings. Results： The T-staging accuracy of EUS （71.1%） was similar to the accuracy of HCT （65.8%）.The accuracy of EUS and HCT in the T1,T2-staging were 71.4% and 14.3%, respectively （P=0.05）.N-staging accuracy of both methods was similar when the fourth edition of the TNM classification was used （EUS 76.3%, HCT 65.8%）. when the fifth edition of the TNM classification was used, the N-staging accuracy of EUS （60.5%） was similar to the accuracy of HCT （63.2%）, too. The sensitivity and specificity of EUS in M-staging were 30.0% and 96.4%, respectively. The sensitivity and specificity of HCT in M-staging were 80.0 % and 92.9%, respectively. Conclusion： The accuracy of EUS and HCT in the TNM staging of gastric cancer are high, but there is no significant influence on the accuracy of N-staging by EUS or HCT using the new TNM classification.

关 键 词：胃肿瘤 内镜超声检查 计算机断层扫描 分期 

分 类 号：R735.7[医药卫生—肿瘤] R735.2[医药卫生—临床医学]