直肠超声对直肠癌分期与淋巴结转移研究  

Study on the Staging and Metastatic Lymph Nodes of Rectal Cancers with Endorectal Ultrasonography

作　　者：林礼务[1] 叶真[1] 薜恩生[1] 高上达[1] 何以敉[1] 

机构地区：[1]福建医科大学附属协和医院

出　　处：《中华超声影像学杂志》1998年第2期91-95,共5页Chinese Journal of Ultrasonography

摘　　要：为探讨直肠超声对直肠癌分期的准确性，对１２２例临床确诊为直肠肿瘤的病人进行直肠超声，指诊及ＣＴ扫描的术前分期对比研究，并对照术后病理分期，以评价直肠超声的临床应用价值。１２２例均分别经直肠超声、指诊及ＣＴ扫描检查并分期。直肠超声采用Ａｌｏｋａ－２５６超声仪附带７．５ＭＨｚ直肠双平面探头。先行指诊与直肠镜检查，确定病变部位，再行直肠超声检查。结果直肠超声对直肠癌分期准确性为９４％（１１５／１２２）显著高于指诊５９％（７２／１２２）与ＣＴ扫描６４％（７８／１２２），Ｐ值＜０．００１。直肠超声对癌的淋巴结转移诊断正确率为８９％（１０８／１２２），它明显高于指诊４８％（５８／１２２）与ＣＴ５１％（６２／１２２），Ｐ值＜０．００１。直肠狭窄与上段直肠病变是直肠超声的主要局限因素，研究表明小于５ｍｍ的淋巴结假阳性高，位于直肠上段病变的淋巴结转移常因超越病变水平而造成假阴性。直肠超声对直肠癌的分期与淋巴结转移诊断有很高的准确性，对指导临床治疗与随诊有重要价值。In order to investigate the accurate rate of endorectal ultrasonography in the staging of rectal cancers, 122 cases of rectal cancer diagnosed clinically were examined with the endoluminal ultrasund. The results were compared with those obtained by digital and CT examinations so as to apprais the value of clinical application of endoluminal ultrasound. All the cases were examined by the endorectal ultrasound digital and CT examinations. The equipment used was Aloka256 with 7.5MHz biplane endoluminal transducer. The digital examination and the rectoscopy were operated first to detect the location of the lesion then the endorectal ultrasound was taken. The result showed that the accurate rate of the staging of rectal cancers by the endorectal ultrasound was 94%, makedly higher than that of digital examination (59%) and CT scaning (64%) (P<0.001). The accurate diagnostic rate of the metastatic lymph nodes by the endorectal ultrasound was 89%, also much higher than that of the digital examination (48%) and the CT scaning (51%) (P<0.001). Rectal stenosis and the lesion in the superior section of rectrum are two main limiting factors of the endorectal ultrasound. The study showed that the false positive rate of metastatic lymph node with diameter less than 5 mm was high and the false negative rate of rectal cancer was high when the lesion was located at the proximal segment of rectum. Endorectal ultrasonography has high accuracte rate in the staging of rectal cancer and deftection of metastatic metastatic lymph nodes. It also has important value in guiding clinical treatment and following up.

关 键 词：直肠超声 直肠癌 超声波诊断 淋巴结转移 

分 类 号：R735.370.4[医药卫生—肿瘤]