食管癌术前超声内镜T、N分期与术后病理T、N分期的比较  

The comparison of pathological tumor staging between preoperative findings by endoscopic ultrasonography and traditional postoperative outcomes

作　　者：马跃峰[1] 邢鑫[2] 孔冉冉[1] 马震川 孙良璋[1] 张晋[1] 李少民[1] Ma Yuefeng;Xing Xin;Kong Ranran;Ma Zhenchuan;Sun Liangzhang;Zhang Jin;Li Shaomin(Department of Thoracic Surgery;Department of Health Care for Cadres,the Second Affiliated Hospital of Medical College of Xi＇an Jiaotong University,Shaanxi Xi＇an 710004,China.)

机构地区：[1]西安交通大学第二附属医院胸外科,陕西西安710004 [2]西安交通大学第二附属医院干六病区,陕西西安710004

出　　处：《现代肿瘤医学》2018年第21期3404-3407,共4页Journal of Modern Oncology

摘　　要：目的:探讨超声内镜(endoscopic ultrasonography,EUS)在食管癌术前TNM分期中的诊断价值。方法:回顾分析43例食管癌根治术患者术前超声内镜的T、N分期与术后病理学的T、N分期,以术后病理分期为金标准,比较两种分期的一致性。结果:食管癌术前EUS检查T、N分期的诊断准确率分别为82. 50%和47. 53%,其中T_1为83. 35%、T_2为82. 65%、T_3为82. 32%、T_4为84. 45%,N0为74. 63%、N_1为72. 75%、N_2为55. 35%、N_3为25. 27%。EUS的T分期与病理T分期结果一致性较好(Kappa=0. 724,P <0. 05); EUS的N_0、N_1分期与病理N_0、N_1分期结果一致性较好,而N_2、N_3的一致性则相对较差,但总体一致性比较仍具有统计学意义(Kappa=0. 408,P <0. 05)。结论:EUS判断食管癌T、N分期诊断准确率较高,可作为术前治疗方法选择的重要依据。Objective To evaluate the diagnostic function of endoscopic ultrasonography（EUS）in preoperative pathological tumor staging of esophageal carcinoma. Methods： 43 patients with esophageal carcinoma were enrolled.Compare the preoperative tumor staging obtained by EUS with the traditional postoperative pathological tumor staging.Evaluate the consistency between the two methods. Results： The accurate rate of assessing the depth of tumor infiltration by EUS was 82.50%.The accuracy rate of T staging from T 1 to T 4 was 83.35%,82.65%,82.32%,and 84.45% respectively.The accurate rate of assessing lymph node metastasis by EUS was 47.53% while the exact value from N 0 to N 3 was 74.63%,72.75%,55.35%,and 25.27% respectively.The T and N staging outcomes obtained by EUS was perfectly consistent with traditional pathological outcomes （Kappa=0.724, P 〈0.05,Kappa=0.408, P 〈0.05）. Conclusion： Preoperative staging of esophageal carcinoma by EUS is accurate.EUS could provide vital evidence in choosing appropriate surgical method in ahead of operations.

关 键 词：食管癌 超声内镜 临床分期 

分 类 号：R735.1[医药卫生—肿瘤]