内镜超声对早期胃癌术前分期的评估价值及相关影响因素  

Evaluation value of endoscopic ultrasound in preoperative staging of early gastric cancer and related influencing factors

作　　者：崔征[1] 侯鹏飞[1] 刘伟[1] CUI Zheng;HOU Pengfei;LIU Wei(Department of Gastroenterology,Puyang Oilfield General Hospital,Puyang 457000,He’nan,China)

机构地区：[1]濮阳市油田总医院消化内科,河南濮阳4570000

出　　处：《癌症进展》2021年第5期475-478,共4页Oncology Progress

摘　　要：目的探讨内镜超声(EUS)对早期胃癌术前分期的评估价值及相关影响因素。方法收集180例术前行EUS检查的早期胃癌患者的临床资料。以术后病理诊断结果为金标准,分析EUS对早期胃癌黏膜下浸润深度的评估价值及EUS对早期胃癌术前分期评估准确性的影响因素。结果180例早期胃癌患者中,经术前EUS检查评估病灶浸润至黏膜内层者106例,浸润至黏膜下层者74例。EUS评估早期胃癌术前分期的灵敏度为62.8%(91/145),特异度为57.1%(20/35),准确度为61.7%(111/180)。多因素分析结果显示,肿瘤直径﹥2 cm是EUS对早期胃癌分期不足的独立危险因素(P﹤0.05),而肿瘤直径﹥2 cm、分化程度为低分化均是EUS对早期胃癌分期过度的独立危险因素(P﹤0.05)。结论EUS对早期胃癌术前分期具有较高的评估价值,而肿瘤直径和分化程度是影响EUS对早期胃癌术前分期评估准确性的重要因素。Objective To evaluate the value of endoscopic ultrasound(EUS)in preoperative staging of early gastric cancer(EGC)and its related influencing factors.Method The clinical data of 180 patients with EGC were collected.All patients were examined by EUS before operation and the definite pathological diagnosis was obtained after operation.Taking the pathological diagnosis results as the gold standard,the evaluation value of EUS in the depth of submucosal invasio in EGC and the multivariate Logistic regression model was used to analyze the influencing factors of the accuracy of EUS in evaluating the preoperative staging of EGC.Result The sensitivity,specificity and accuracy of EUS in preoperative staging of EGC were 62.8%(91/145),57.1%(20/35)and 61.7%(111/180),respectively.By preoperative EUS examination,among 180 patients with,106 cases were diagnosed to infiltrate into the inner mucosa,74 cases were diagnosed to infiltrate into submucosa.Multivariate analysis showed that tumor diameter>2 cm was an independent risk factor for insufficient staging of EGC by EUS(P<0.05),and tumor diameter>2 cm and poorly differentiated degree were independent risk factors for excessive staging of EGC by EUS(P<0.05).Conclusion EUS has a high value in evaluating the depth of submucosal invasion of EGC,and tumor diameter and differentiation degree are important factors affecting the accuracy of EUS in evaluating preoperative staging of EGC.

关 键 词：内镜超声 胃癌 分期 诊断价值 影响因素 

分 类 号：R735.2[医药卫生—肿瘤]