胃癌内镜超声术前分期与PTEN相关性的临床研究  

Clinical study on preoperative endoscopic ultrasonography staging and relationship with the expression of PTEN in gastric carcinoma

作　　者：白景舒[1] 葛楠[1] 乔麟[1] 

机构地区：[1]中国医科大学附属第二医院胆道微创外科,沈阳110001

出　　处：《中国医师进修杂志（外科版）》2008年第11期22-24,共3页Chinese Journal of Postgraduates of Medicine

基　　金：辽宁省教育厅高等学校计划项目（202013181）

摘　　要：目的探讨内镜超声（EUS）检查在胃癌术前分期的应用价值及影像学改变的分子生物学基础。方法对74例胃癌患者进行术前EUS检查。EUS术前分期分别与术后病理分期以及抑癌基因PTEN在胃癌的表达进行比较。结果对比术后病理结果，EUS术前对T分期总准确率为82．4％（61/74），T1、T2、T3、T4分期的准确率分别为100．0％、72．7％、85．0％和78．9％。EUS术前对N分期总准确率为74．3％（55/74），敏感度为80．8％，特异度为59．1％。胃癌EUS术前T分期和N分期与PTEN表达水平呈负相关（P〈0．05）。结论EUS能够有效地在术前判断胃癌的浸润深度和淋巴结转移，但仍有分期过度和不足的倾向及对良、恶性淋巴结的鉴别有待提高。EUS对胃癌的术前分期具有其分子病理学改变的基础。Objective To evaluate endoscopic ultrasonography （EUS） in preoperative staging of gastric carcinoma, and to study the molecular biologic basis of its ultrasonic manifestation. Methods Seventy-four patients with gastric carcinoma were referred to EUS and staged preoperatively. The staging results of EUS were compared with the histopathological staging and the expression of PTEN. Results The overall accuracy rate of EUS for determination ofT staging was 82.4%（61/74）, for T1, T2, T3 and T4 were 100.0%, 72.7%, 85.0% and 78.9% , respectively. For N staging, EUS had the overall accuracy rate of 74.3% （55/74）, with sensitivity and specificity of 80.8% and 59.1%, respectively. The preoperative EUS for T and N staging of gastric carcinoma was of inverse correlation with the expression of PTEN. Conclusions EUS is an accurate staging modality in determining carcinoma invasive depth and lymph node involved, with a few exceptions of overstaging and understaging. However,EUS criteria to differentiate benign from malignant nodes still need to be further defined by future studies. The preoperative EUS for T and N staging could well display the molecular pathologic basis of gastric carcinoma.

关 键 词：胃肿瘤 腔内超声检查 肿瘤分期 病理学 外科 

分 类 号：R737.9[医药卫生—肿瘤] R735.2[医药卫生—临床医学]