术前小探头超声内镜检查在早期胃癌治疗方式选择中的作用  

Effects of mini-probe endoscopic ultrasonography for therapeutic decision-making in early gastric cancer prior to operation

作　　者：王警[1] 吴齐[1] 孙利[2] 李子禹[3] 步召德[3] 苏向前[3] 李士杰[1] 

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所恶性肿瘤发病机制及转化研究教育部重点实验室内镜中心,北京100142 [2]北京大学肿瘤医院暨北京市肿瘤防治研究所恶性肿瘤发病机制及转化研究教育部重点实验室病理科,北京100142 [3]北京大学肿瘤医院暨北京市肿瘤防治研究所恶性肿瘤发病机制及转化研究教育部重点实验室胃肠肿瘤中心,北京100142

出　　处：《中国内镜杂志》2016年第2期15-21,共7页China Journal of Endoscopy

基　　金：北京市属医院科研培育计划(No:PX2016057)

摘　　要：目的评价小探头超声内镜(EUS)在早期胃癌(EGC)治疗方式选择中的作用。方法回顾性分析2011年1月-2013年12月北京大学肿瘤医院151例单发EGC临床病理资料。分析EUS判断EGC浸润深度的准确率及影响因素,评价基于EUS选择EGC治疗方法的策略。结果 EUS对EGC浸润深度判断的准确率为74.8%。多因素分析结果显示,肿瘤直径>2 cm、内镜下溃疡形成及病灶位于胃中上2/3是导致分期错误的危险因素(P<0.05)。75.3%(107/142)的EGC病例通过基于EUS评估获得了适合的治疗。结论小探头EUS在EGC浸润深度评估及治疗方式选择中具有良好实用性,当病灶直径大于2 cm、合并溃疡形成或位于胃中上部时,应当谨慎对待EUS结果。Objective To evaluate the clinical value of mini-probe endoscopic ultrasonography（EUS） in determining the therapeutic strategy for early gastric cancer（EGC） before surgery. Methods 151 EGC lesions were enrolled in the study. The accuracy of EUS-determined depths were compared with histopathologic results, and the effects of EUS-based therapeutic decision-making plan was evaluated. Results The overall accuracy of EUS-determined T staging was 74.8 %. Multivariate analysis revealed that tumor size larger than 2 cm, endoscopic ulceration and tumor located at upper two thirds of the stomach were associated with EUS misdiagnosis（P〈0.05）. 75.3 %（107/142） of the EGC patients received proper treatment according to EUS-based therapeutic selection. Conclusions Mini-probe EUS is a useful utility in T-staging and therapeutic strategy selection for EGC. Special attention should be paid when tumor diameter exceeds 2 cm, co-existence of ulcer or tumor located in the upper two-thirds portion of the stomach.

关 键 词：超声内镜 早期胃癌 诊断 治疗 

分 类 号：R735.2[医药卫生—肿瘤]