直肠腔内360°超声和腔内矢状面超声在全段直肠癌术前TN分期和环周切缘中的应用价值  

Application Value of Three-dimensional Transrectal Ultrasound and Sagittal Transrectal Ultrasound in Preoperative T/N-staging and CRM of Rectal Cancer

作　　者：陈东[1] 陈海涛[1] 李支尧[1] 唐诗聪 钏志睿 张映贤 罗晓茂[1] CHEN Dong;CHEN Hai-tao;LI Zhi-yao;TANG Shi-cong;CHUAN Zhi-rui;ZHANG Ying-xian;LUO Xiao-mao(Dept.of Ultrasound,The 3rd Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650118,China;Dept.of Breast Surgery,The 3rd Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650118,China)

机构地区：[1]昆明医科大学第三附属医院超声医学科,云南昆明650118 [2]昆明医科大学第三附属医院乳腺外一科,云南昆明650118

出　　处：《昆明医科大学学报》2020年第7期38-42,共5页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(81960542);云南省教育厅科学研究基金资助项目(2019J1288)。

摘　　要：目的评估直肠腔内360°超声和腔内矢状面超声在全段直肠癌术前T分期、N分期和环周切缘中的诊断价值。方法选取昆明医科大学第三附属医院结直肠外科诊治的111例直肠癌患者,其中71例中下段无肠腔狭窄的直肠癌用360°腔内超声检查,40例上段直肠癌用腔内凸阵探头矢状面超声检查,与术后病理结果对比,比较其对TN分期和评估环周切缘的状态的诊断效能。结果直肠腔内360°超声和腔内矢状面超声对直肠癌术前T分期和N分期的准确性分别为87.4%(kappa=0.819,P<0.001)、74.8%(kappa=0.572,P<0.001),其对环周切缘的诊断准确性为94.6%。结论直肠腔内360°超声和腔内矢状面超声在全段直肠癌的术前评估中具有较高的诊断准确率和一致性,二者联合应用可提高腔内超声在全段直肠癌术前分期中的诊断价值。Objective To evaluate the value of three-dimensional transrectal ultrasound(3 D-ERUS)and sagittal transrectal ultrasound in preoperative TN-staging and circumferential resection margin(CRM)of rectal cancer.Methods A total of 111 patients with rectal cancer were selected from our hospital.Among them,71 cases of middle and lower rectal cancer were examined by 3 D-ERUS,40 cases of upper rectal cancer were examined by sagittal transrectal ultrasound.The pathological results were used to compare the accuracy of rectal cancer TN-staging and CRM using 3 D-ERUS and sagittal transrectal ultrasound.Results The overall accuracy of preoperative T/N-stage of rectal cancer were 87.4%(kappa=0.819,P<0.001)and 74.8%(kappa=0.572,P<0.001),respectively,and the accuracy of CRM was 94.6%.Conclusions The preoperative evaluation of total rectal cancer by 3 D-ERUS and sagittal transrectal ultrasound has high diagnostic accuracy and consistency.Combined application can improve the diagnostic value of transrectal ultrasound in preoperative staging of total rectal cancer.

关 键 词：直肠癌 直肠腔内360°超声 术前分期 环周切缘 

分 类 号：R735.37[医药卫生—肿瘤]