口服胃肠超声造影在老年人胃肿瘤诊断中的应用价值  

Application value of oral contrast-enhanced ultrasonography in the diagnosis of gastric tumors in the elderly

作　　者：王川予[1] 陈秀华[1] 刘媛[1] 范小晶[1] 王薇[2] 周新平[3] 艾欣 杜俊[4] 戴维德[1] Wang Chuanyu;Chen Xiuhua;Liu Yuan;Fan Xiaojing;Wang Wei;Zhou Xinping;Ai Xin;Du Jun;Dai Weide(Department of Ultrasonography,Beijing Hospital,National Center of Gerontology,Beijing 100730,China;Gastroscopy Room,Beijing Hospital,National Center of Gerontology,Beijing 100730,China;Department of General Surgery,Beijing Hospital,National Center of Gerontology,Beijing 100730,China;Department of Pathology,Beijing Hospital,National Center of Gerontology,Beijing 100730,China)

机构地区：[1]北京医院超声科国家老年医学中心,100730 [2]北京医院胃镜室国家老年医学中心,100730 [3]北京医院普外科,国家老年医学中心,100730 [4]北京医院病理科,国家老年医学中心,100730

出　　处：《中华老年医学杂志》2019年第11期1262-1265,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨口服胃肠超声造影对老年人胃肿瘤的诊断价值。方法应用口服胃肠超声造影技术及电子胃镜,与金标准手术病理对比,对42例诊断为胃肿瘤的老年患者进行对照分析。结果42例老年胃肿瘤患者,经口服胃肠超声造影诊断胃癌的共40例患者,与手术病理结果比较,口服胃肠超声造影诊断胃癌符合率95.2%(40/42),Kappa值为0.812(P<0.05);与手术病理结果比较,电子胃镜符合率90.5%(38/42),Kappa值为0.718(P<0.05)。对比手术病理诊断,口服胃肠超声造影TNM分期的诊断符合率(准确率)分别为T1期95.0%(38/40)、T2期95.0%(38/40)、T3期100.0%(40/40)、T4期100.0%(40/40),对T3、T4期敏感度及特异度均达到100.0%;口服胃肠超声造影对NM期诊断符合率N095.0%(38/40)、N1~N3期95.0%(38/40),M0及M1期均为100.0%(40/40)。结论针对老年人胃肿瘤,口服胃肠超声造影检查方法简单、无痛苦、无损伤,肿瘤定性符合率与胃镜符合率相近,可作为老年人胃肿瘤检查的首选方法,且对胃肿瘤TNM分期诊断准确度较高,与电子胃镜检查结合应用,可为老年人胃肿瘤治疗方案的选择及预后评估提供更可靠的依据。Objective To investigate the diagnostic value of ultrasonography.in elderly patients with gastric tumors.Methods A total of 42 elderly patients with gastric tumors confirmed by surgery pathology underwent oral contrast-enhanced ultrasonography and electronic gastroscopy.The diagnostic effect of oral contrast-enhanced ultrasonography and electronic gastroscopy were compared based on the gold standard of surgical pathology.Results Of the 42 elderly patients with gastric tumors,40 patients were diagnosed by oral contrast-enhanced ultrasonography and the surgical pathology(40/42,95.2%),with Kappa value of 0.812.And 38 cases were diagnosed by electronic gastroscopy and the surgical pathology(38/42,90.5%),with Kappa value of 0.718(P<0.05).Based on gold standard of surgical pathology results,the accuracies of T1,T2,T3 and T4 stage by oral contrast-enhanced ultrasonography were 95.0%(38/40),95.0%(38/40),100.0%(40/40)and 100.0%(40/40),respectively.The sensitivity and specificity of T3 and T4 stage for oral contrast-enhanced ultrasonography reached to 100.0%.The diagnostic accuracies of N0,N1-N3,M0 and M1 by oral contrast-enhanced ultrasonography were 95.0%(38/40),95.0%(38/40),100.0%(40/40)and 100.0%(40/40).Conclusions Oral contrast-enhanced ultrasonography is a simple,painless and non-invasive method for the diagnosis of gastric tumors in the elderly.And its qualitative coincidence rate of the tumors diagnosis is similar to that of gastroscopy.So it can be used as the first choice for the examination of gastric tumors in the elderly.Oral contrast-enhanced ultrasonography has a high diagnostic accuracy on TNM staging of gastric tumor.When combined with electronic gastroscopy,it may provide a more reliable basis for the choice of evaluation of treatment and prognosis in elderly patients with gastric tumor.

关 键 词：胃肿瘤 超声检查 胃镜检查 

分 类 号：R73[医药卫生—肿瘤]