直肠指检对直肠癌术前评估意义的临床研究  

A Clinical Research for the Significance of Digital Rectal Examination for Preoperative Assessment of the Rectal Cancers

作　　者：吴华强[1] 庄文[2] 左明[3] 

机构地区：[1]富顺县人民医院普外科,四川富顺643200 [2]四川大学华西医院胃肠外科,成都610041 [3]四川省肿瘤医院大肠外科,成都610041

出　　处：《肿瘤预防与治疗》2011年第3期191-193,共3页Journal of Cancer Control And Treatment

摘　　要：目的:探讨直肠指检在直肠癌术前评估中的临床意义。方法:前瞻性纳入163例直肠癌患者,行直肠指检,判断肿瘤下缘距肛缘距离、肿瘤大体类型及浸润肠壁周径长度和浸润深度等指标,以术后病理检查诊断为"金标准",分析直肠指检对上述指标在术前评估中的准确率。结果:直肠指检对超低位直肠癌肿瘤下缘距肛缘距离的评估有较高的准确性,距肛缘3cm～6cm者准确率为83%～100%;对环周度判断准确率为82%～95%;大体类型准确率为82%～100%;如直肠癌肿瘤未浸穿肠壁,对浸润深度判断准确率为78%～100%。但对7cm～10cm以上直肠癌距肛缘距离的评估准确性不高(准确率14%～58%),对浸出肠壁的直肠癌浸润深度判断不是非常准确(准确率31%)。结论:直肠指检对低位早期直肠癌的术前评估有重要意义,可较准确地评估直肠癌患者局部病情进展情况,为进一步检查治疗提供重要参考。Objective： To assess the value of the digital examination for rectal cancer before operation. Methods： 163 patients diagnosed as rectal cancer were prospectively enrolled into this study. All patients were performed digital examination to assess the distance from tumor＇ s inferior border to anal, the infiltration depth, the macroscopic pathology and the circulus degree. Then the results were compared with the pathologic assessing after operation. Results： Digital examination had an excellent accuracy rate for assessing infiltration depth （78% - 100% ）, circulus（82% -95% ）, macroscopic pathology（82% -100% ） and the distance from super-low rectal carcer＇ s （3cm -6cm） inferior border to anal（ 83%- 100% ）. Conclusion： Digital examination has a high value to assess the patients＇ condition before operative procedures for rectal cancer.

关 键 词：直肠指检 直肠癌 术前评估 

分 类 号：R735.37[医药卫生—肿瘤]