经直肠超声在评价直肠癌术前新辅助放化疗疗效中的价值  

The Evaluation of Rectal Cancer with Neoadjuvant Therapy by Endorectal Ultrasonography

作　　者：叶卫华[1] 王贵英[2] 韩若凌[1] 孟洁[1] 

机构地区：[1]河北医科大学第四医院超声科,石家庄市050011 [2]河北医科大学第四医院外二科,石家庄市050011

出　　处：《中国超声医学杂志》2013年第4期351-354,共4页Chinese Journal of Ultrasound in Medicine

基　　金：河北省高校强势特色学科一第四医院肿瘤学支持项目(冀教高No.[2005]52);河北省卫生厅课题(医学科学研究重点课题计划No.20090521)

摘　　要：目的探讨经直肠超声（endorectalultrasonography，ERUS）对中低位进展期直肠癌术前新辅助放化疗前后在疾病缓解、肿瘤分期变化方面疗效评价的价值。方法选取行新辅助放化疗的T3、T4期直肠癌患者38例，观察所有患者新辅助治疗前后的声像图变化进行回顾性分析。结果38例直肠癌患者完成新辅助放化疗后，通过腔内超声检查、病理组织片，发现2例（5．26％）肿瘤病灶消失，为病理完全缓解，32例（84．21％）肿瘤不同程度缩小；1例（2．63％）病情稳定，3例（7．89％）病情进展。术前经直肠腔内超声判断肿瘤大小变化的准确率为100％。术后病理T分期与治疗前进行比较，经χ2检验，P〈0．05，差异有统计学意义，肿瘤降期明显。直肠腔内超声术前T分期的总准确率为89．47％（34／38）。结论经直肠超声可有效的评价新辅助治疗前后直肠病灶的改变，可用于新辅助治疗的疗效的评价。Objective To evaluate the effect of patients with neoadjuvant chemoradiotherapy on down-staging by endorectal ultrasonograpy in mid-low advanced rectal cancer. Methods We randomly assigned 38 patients with mid low rectal cancer on clinical stage T3 or T4 to receive preoperative chemoradiotherapy. Retrospective ultrasonogram was studied before and after neoadjuvant chemoradiotherapy. Results After chemoradiotherapy 2 of 38 patients （5.26%） performed yeild-pathological complete response（ypCR）. 32 cases（84.21%） performed partial response （PR）. 1 case （2.63 % ）performed stable disease（SD）. 3 case （7.89 %） performed progressive disease（PD）. The evalu- ation accuracy of neoadjuvant chemothearapy effects on tumorsr size was-100% by endorectal ultrasonograpy. Com- pared with pre-therapy, down-staging was significant after preoperative chemoradiotherapy by χ2 test（P〈0.05）. The diagnostic accuracy rate of rectal cancer T staging was 89.47%. Conclusions Endorectal ultrasonograpy can effectively evaluate the effect of neoadjuvant chemoradiotherapy.

关 键 词：中低位进展期直肠癌 新辅助放化疗 经直肠超声 肿瘤降期 

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