超声内镜联合经内镜微探头在食管癌T、N分期中的价值  

The staging value of endoscopic ultrasonography combined transendoscopic miniatureprobe in T,N staging of esophageal cancer

作　　者：杨莹莹[1] 沈小春[1] 樊玲[1] 兰春慧[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所消化内科,重庆400042

出　　处：《检验医学与临床》2016年第11期1515-1517,共3页Laboratory Medicine and Clinic

摘　　要：目的对比超声内镜(EUS)和经内镜微探头(TEMP)检查以及两者联合应用在食管癌术前进行T、N分期中的准确性,探讨两者联合应用在食管癌临床分期中的价值。方法对347例初治食管癌患者分别进行EUS和TEMP及EUS联合TEMP检查,并同时进行T、N分期,以术后病理为金标准。结果 EUS、TEMP和EUS联合TEMP组判断食管癌侵犯深度即T分期的正确率分别为77.8%、79.5%和92.5%,EUS联合TEMP组较单用EUS和TEMP的正确率高出14.7%和13.0%,差异有统计学意义(P<0.05);判断周围淋巴结转移的阳性率即N分期的正确率分别为75.0%、56.4%和90.5%,EUS联合TEMP组较单用EUS和TEMP的正确率高出15.6%和34.2%,差异有统计学意义(P<0.05)。结论 EUS联合TEMP能更准确地对食管癌进行T、N分期,EUS对食管壁增生显著,但未狭窄者以及淋巴转移的判断更具优势,TEMP对早期病变及食管腔梗阻者更适合,采用何种超声诊断应根据患者普通胃镜检查结果有针对性地进行选择,两种方法联合应用并结合各自优势进行诊断能显著提高食管癌T、N分期的正确率。Objective To compare the accuracy of endoscopic ultrasonography（EUS）,transendoscopic miniatureprobe（TEMP）and their combination in the conduct preoperative T,N staging.To evaluate the diagnostic value of their combination in preoperative T,N staging of esophageal carcinoma.Methods Totally 347 patients with esophageal carcinoma were subjected to preoperative T,N staging by EUS,TEMP and their combination postoperative pathological staging.The pathology took as the gold standard.Results EUS,TEMP and the combined group to determine depth of invasion（T staging）of esophageal correct rates were 77.8%,79.5% and 92.5%.The combination group compared with EUS and TEMP which the correct rate were high than 14.7% and13.0%,the difference was statistically significant（P〈0.05）.The correct rate of positive rate of lymph node metastasis（N staging）were 75.0%,56.4% and 90.5%.The combination group compared with EUS and TEMP which the correct rate were high than15.6% and 34.2%（P〈0.05）.Conclusion EUS combined TEMP can be more accurately to T,N staging of esophageal cancer.EUS have an advantage for esophageal wall significant hyperplasia but not stenosis and lymph node metastasis.TEMP is more suitable for early lesions and esophageal lumen obstruction.What is the use of ultrasound diagnosis should be based on the results of endoscopy in patients with common targeted selection.And combining the two methods combined with their respective advantages and diagnosis can significantly improve the accuracy of esophageal cancer T,N staging.

关 键 词：超声胃镜 超声微探头 食管癌 TN分期 

分 类 号：R735.2[医药卫生—肿瘤]