腹腔镜下胃癌分期的准确性及对治疗方案选择的影响  

Accuracy of Laparoscopic Gastric Cancer Staging and Its Effect on Treatment Options

作　　者：李小刚[1] 闫斌[1] 贾志勇 王家宏[1] LI Xiao-gang;YAN Bin;JIA Zhi-yong;WANG Jia-hong(The Second Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou,Inner Mongolia,014010 China)

机构地区：[1]内蒙古科技大学包头医学院第一附属医院普外二科

出　　处：《中外医疗》2019年第23期38-40,共3页China & Foreign Medical Treatment

摘　　要：目的评价腹腔镜下胃癌分期的效果,以及其对治疗方案的影响,评价腹腔镜胃癌分期诊断术的价值。方法2015年1月-2017年12月,包头医学院第一附属医院共采用腹腔镜分期诊断术进行胃癌分期124例,回顾性分析,评价腹腔镜分期与病理T、N、M分期的一致性。结果腹腔镜对T2、T3、T4分期的灵敏度、特异度均在85.00%以上,整体分期的符合率为87.90%。一致性分析Kappa检验,一致性为0.847,属于高度一致。腹腔镜对N0-3分期的灵敏度、特异度均在60.00%~80.00%之间,整体分期的符合率为71.77%。一致性分析Kappa检验,一致性为0.653,属于中度一致。腹腔镜分期与病理M分期的kappa一致性系数k=0.891,属高度一致,对M0分期的灵敏度92.73%,特异度71.43%。与手术结果相比较,腹腔镜拟定治疗术方案与结果一致性为96.77%(120/124)。结论腹腔镜下胃癌分期的准确性较好,特别是对T、M分期的符合率较高,据此拟定治疗策略的较好。Objective To evaluate the effect of laparoscopic gastric staging and its effect on treatment options,and to evaluate the value of laparoscopic gastric cancer staging.Methods From January 2015 to December 2017,the First Affiliated Hospital of Baotou Medical College used laparoscopic staging diagnosis for 124 cases of gastric cancer staging.Retrospective analysis was performed to evaluate the consistency of laparoscopic staging with pathological T,N,and M staging.Results The sensitivity and specificity of laparoscopic T2,T3 and T4 staging were above 85.00%,and the overall staging rate was 87.90%.The Kappa test for consistency analysis,with a consistency of 0.847.The sensitivity and specificity of laparoscopic N0-3 staging were between 60.00% and 80.00%,and the overall staging rate was 71.77%.Consistency analysis Kappa test,consistency was 0.653,which was moderately consistent.The kappa consistency coefficient of laparoscopic staging and pathological M stage was k=0.891,which was highly consistent.The sensitivity to M0 stage was 92.73% and the specificity was 71.43%.Compared with the surgical results,the consistency of the laparoscopic treatment protocol and results was 96.77%(120/124).Conclusion The accuracy of laparoscopic gastric cancer staging is better,especially the coincidence rate of T and M staging.According to this,the treatment strategy is better.

关 键 词：胃癌 分期 腹腔镜 

分 类 号：R735[医药卫生—肿瘤]