EUS判断胃癌术前病理学特点的应用价值  

The application value of EUS in judging preoperative pathological characteristics of gastric cancer

作　　者：朱志超 樊荣荣 徐宝宏[1] 郑星梅 ZHU Zhichao;FAN Rongrong;XU Baohong;ZHENG Xingmei(Department of Gastroenterology Beijing luhe hospital capital medical university 101101 China;Department of Gastroenterology Linfen Central Hospital 041099 China)

机构地区：[1]首都医科大学附属北京潞河医院消化内科,101101 [2]临汾市中心医院消化内科,041099

出　　处：《现代消化及介入诊疗》2019年第1期29-31,35,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：北京市医院管理局临床技术创新项目(XMLX201414);北京市优秀人才培养资助(2011D003034000009)

摘　　要：目的探讨小探头内镜超声(EUS)在判断胃癌术前病理学特点中的应用价值。方法选取我院2016年3月至2018年5月确诊的104例胃癌患者,所有患者均经手术后病理学检查证实,在手术前所有患者均接受了EUS检查,对比术后病理学与术前EUS判断病理学分期、肿瘤浸润深度的差异。结果术前EUS判断与术后病理学位的符合率为:病变部位上1/3的符合率为90.00%、中1/3的符合率为89.47%、下1/3的符合率为95.65%;病灶直径:≥3 cm的符合率为91.84%、<3 cm的符合率为89.09%;病变分化类型:分化型82.80%、未分化型72.73%;对于T1期患者,EUS诊断分级提高诊断分级2例; T2期患者,EUS降低诊断分级1例、提高诊断分级7例; T3分期患者,EUS降低诊断分级2例、提高诊断分级4例; T4期患者,EUS降低诊断分级2例; EUS术前判断胃癌患者的T分期与术后病理学结果的一致性Kappa值=0.755,P<0.001;对于N0期患者,EUS诊断分级提高诊断分级2例; N1期患者,EUS降低诊断分级2例、提高诊断分级9例; N2分期患者,EUS降低诊断分级3例、提高诊断分级5例; N3期患者,EUS降低诊断分级1例; EUS术前判断胃癌患者的T分期与术后病理学结果的一致性Kappa值=0.680,P<0.001。结论 EUS在判断胃癌术前病理学分期、病理学特点中具有与病理学较高的一致性和符合率。Objective To study the clinical value of small probe endoscopic ultrasonography EUS in preoperative pathological staging and pathological features of gastric cancer.Methods 104 patients with gastric cancer diagnosed from March 2016 to May 2018 in our hospital were selected.All patients were confirmed by postoperative pathological examination.All patients underwent EUS examination before operation.The postoperative pathology and preoperative EUS were compared.Determine the difference in pathological stage and depth of tumor invasion.Results The coincidence rate of preoperative EUS judgment and postoperative pathology degree was the coincidence rate of 1/3 of the lesion site was 90.00%the coincidence rate of middle 1/3 was 89.47%and the coincidence rate of the lower 1/3 was 95.65%Diameter the coincidence rate of ≥3 cm is 91.84%the coincidence rate of<3 cm is 89.09%the type of lesion differentiation 82.80%of differentiated type 72.73%of undifferentiated type for patients with T1 the diagnostic grade of EUS is improved by 2 cases T2 Patients with EUS reduced diagnostic grade in 1 case and improved diagnostic grade in 7 cases T3 staged patients EUS reduced diagnostic grade in 2 cases improved diagnostic grade in 4 cases T4 stage EUS reduced diagnostic grade in 2 cases EUS preoperative judgment of gastric cancer patients The Kappa value of the T stage and the postoperative pathological results was 0.755 P<0.001.For the N0 patients the EUS diagnostic grade improved the diagnostic grade in 2 cases in the N1 stage the EUS reduced the diagnostic grade in 2 cases and improved the diagnostic grade 9 For example in N2 staging patients EUS reduced the diagnostic grade in 3 cases and improved the diagnostic grade in 5 cases in N3 stage EUS reduced the diagnostic grade in 1 case EUS preoperatively judged the consistent Kappa value of T stage and postoperative pathological results of gastric cancer patients.Kappa value=0.680 P<0.001.Conclusion EUS has a high degree of consistency and coincidence with pathology in preoperative p

关 键 词：小探头内镜超声 胃癌 病理学分期 病理学特点 

分 类 号：R735.2[医药卫生—肿瘤]