直肠腔内超声对T3期直肠癌环周切缘和肿瘤最大厚度的判断价值  

Value of endorectal ultasound in predicting the circumferential resection margin and maximum tumor thickness of T3 rectal cancer

作　　者：仲光熙[1] 肖毅[2] 张璟[1] 戴晴[1] 李建初[1] 姜玉新[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院超声医学科,100730 [2]中国医学科学院北京协和医学院北京协和医院基本外科,100730

出　　处：《中华胃肠外科杂志》2015年第3期252-256,共5页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的：评估直肠腔内超声（ERUS）对T3期直肠癌的环周切缘（CRM）及肿瘤最大厚度（MTT）的诊断准确性。方法回顾性分析2011年6月至2014年1月，北京协和医院基本外科收治的53例pT3期直肠癌病例资料。将ERUS测量的CRM和MTT与相对应的病理测量值进行比较，评估ERUS诊断的准确性。结果 ERUS准确判断CRM 52例（98．1％，52／53）；ERUS判断CRM的灵敏度6／6，特异度97．8％（46／47），阳性预测值6／7，阴性预测值100％（46／46）。 ERUS准确诊断MTT 51例（96．2％，51／53），ERUS诊断MTT的灵敏度4／4，特异度95．9％（47／49），阳性预测值4／6，阴性预测值100％（47／47）。Bland-Altman散点图显示，ERUS测量与病理测量的一致性较好。结论直肠腔内超声能准确判断CRM和MTT，较好的满足临床对直肠癌术前分期的要求。Objective To evaluate the accuracy of endorectal ultrasound （ERUS） in predicting the circumferential resection margin （CRM） and maximum tumor thickness （MTT） of in T3 rectal cancer. Methods Clinicl data of 53 patients with pT3 rectal cancer admitted to the Department of General Surgery in the Peking Union Medical College Hospital from June 2011 to January 2014 were retrospectively analyzed. CRM and MTT measured by ERUS were compared with corresponding pathologic measurements to assess the accuracy of ERUS diagnosis. Results ERUS correctly predicted CRM status in 52 patients （98.1%, 52/53）, whose sensitivity was 100%, specificity was 97.8%, positive predictive value was 85.7%, and negative predictive value was 100%. ERUS correctly predicted MTT status in 51 patients （96.2%, 51/53）, whose sensitivity was 100%, specificity was 95.5%, positive predictive value was 66.6%, and negative predictive value was 100%. In the Bland and Altman plot, the agreement between ERUS and pathology was good. Conclusion Endorectal ultrasonography can accurately diagnose CRM and MTT, which can satisfy the clinical need for preoperative staging of rectal cancer.

关 键 词：直肠肿瘤 直肠腔内超声 环周切缘 肿瘤最大厚度 

分 类 号：R735.37[医药卫生—肿瘤]