腔内超声联合血清癌胚抗原检测对直肠癌分期的诊断  

Diagnostic Value of Transrectal Ultrasonography Combined with Serum Carcinoembryonic Antigen Detection in Preoperative Staging of Rectal Carcinoma

作　　者：胡杨柳[1] 陈莉[2] 李卫平[1] 

机构地区：[1]江西护理职业技术学院医学技术系,南昌330029 [2]南昌大学第一附属医院超声诊断科,南昌330006

出　　处：《南昌大学学报（医学版）》2012年第12期67-69,89,F0003,共5页Journal of Nanchang University：Medical Sciences

摘　　要：目的研究腔内超声(TRUS)对直肠癌术前分期的诊断价值,并探讨TRUS联合血清癌胚抗原(CEA)对直肠癌术前分期的可行性。方法 52例经病理证实的直肠癌患者于术前1周内行直肠TRUS检查[行超声分期(uT),判断淋巴结转移情况],并检测术前血清CEA水平。将TRUS、TRUS联合CEA的术前分期结果与术后病理分期(pT)进行对照。结果与术后pT结果对照,TRUS对52例直肠癌术前分期的准确率为76.9%,而TRUS联合CEA的准确率达88.5%,两者比较差异有统计学意义(P<0.05)。uT1、uT2、uT3、uT4分期诊断准确率分别为75.0%、68.7%、72.7%、100.0%。pT1-pT4各期之间血清CEA值、血清CEA阳性率差异有统计学意义(P<0.05),随着病理分期程度的加深血清CEA值明显升高。有淋巴结转移者较无转移者血清CEA值升高(P<0.001)。结论直肠TRUS对直肠癌浸润深度以及肠周淋巴结转移的诊断具有较高的准确性,可作为直肠癌术前分期的诊断方法之一。术前血清CEA值对直肠癌TRUS分期有着参考价值,TRUS结合血清CEA值可提高对直肠癌术前分期的准确率。Objective To investigate the diagnostic value of transrectal ultrasonography(TRUS) in preoperative staging of rectal carcinoma,and to explore the feasibility of the combination of TRUS and serum carcinoembryonic antigen(CEA) detection for preoperative staging of rectal carcinoma.Methods The TRUS was performed for tumor staging and lymph node metastasis and serum CEA levels were measured within 1 week before operation in patients with pathologically confirmed rectal carcinoma.Preoperative staging of rectal carcinoma by TRUS or in combination with CEA detection was compared with postoperative pathological findings.Results The combination of TRUS and CEA detection showed a significantly higher accuracy than TRUS alone for preoperative staging of rectal carcinoma(88.5% vs 76.9%,P<0.05).The accuracies of TRUS for uT1,uT2,uT3 and uT4 carcinoma were 75.0%,68.7%,72.7% and 100.0%,respectively.There were obvious differences in levels and positive rates of serum CEA among pT1,pT2,pT3 and pT4(P<0.05). Moreover,serum CEA levels were positively correlated with pathological stage and lymph node metastasis.Conclusion The TRUS provides an alternative method for preoperative staging of rectal carcinoma with a higher accuracy for the diagnosis of rectal cancer invasion and lymph node metastasis.Preoperative serum CEA levels can be used as a reference to increase the accuracy of TRUS for preoperative staging of rectal carcinoma.

关 键 词：直肠腔内超声 直肠癌 血清癌胚抗原 术前分期 

分 类 号：R735.37[医药卫生—肿瘤] R445.1[医药卫生—临床医学]