MRI及直肠腔内超声诊断低位直肠癌术前T分期的准确度分析  

Accuracy of MRI and endorectal ultrasonography in preoperative clinical T staging of distal rectal cancer

作　　者：庄咏 吴贤毅[1] 卓长华[1] 余辉[1] 杨春康[1] ZHUANG Yong;WU Xianyi;ZHUO Changhua;YU Hui;YANG Chunkang(Department of Gastrointestinal Surgery,Fujian Cancer Hospital/Fujian Medical University Cancer Hospital,Fuzhou 350014,Fujian,China)

机构地区：[1]福建省肿瘤医院/福建医科大学附属肿瘤医院胃肠外科,福州350014

出　　处：《癌症进展》2021年第12期1223-1225,共3页Oncology Progress

摘　　要：目的比较MRI及直肠腔内超声(ERUS)诊断低位直肠癌术前T分期的准确性,探讨MRI及ERUS在低位直肠癌术前分期中的应用价值。方法选取43例低位直肠癌患者,临床分期为T1~2N0M0期的病例为直接手术组,行MRI及ERUS后1周内接受外科手术;临床分期为T3~4或N+期的病例为放化疗组,同步放化疗结束后8周行MRI及ERUS;以术后病理结果为金标准,分别比较MRI、ERUS术前T分期的准确度及两种检查与术后病理结果的一致性,比较MRI及ERUS对直肠癌术前T分期的诊断效能。结果直接手术组术前MRI T分期准确度为70.8%(17/24),Kappa系数为0.54(P﹤0.01);ERUS T分期准确度为75.0%(18/24),Kappa系数为0.60(P﹤0.01)。放化疗组术前MRI T分期准确度为57.9%(11/19),Kappa系数为0.40(P﹤0.01);ERUS T分期准确度为36.8%(7/19),Kappa系数0.15(P=0.15)。结论MRI及ERUS在直肠癌术前T分期中均具有较高的诊断效能,对放化疗后化疗反应的诊断效能不佳。Objective To compare the accuracy and explore the value of MRI and endorectal ultrasonography(ERUS)for preoperative clinical T staging of distal rectal cancer.Method A total of 43 patients with distal rectal cancer were selected,patients with clinical stage of T1-2N0M0 underwent surgery within 1 week after MRI and ERUS(surgery group)were surgery group,and patients with clinical stage T3-4 or N+underwent MRI and ERUS 8 weeks after chemoradiotherapy were chemoradiotherapy group.The accuracy of preoperative clinical T staging of MRI and ERUS were compared by using postoperative pathology as the gold standard and the consistence of results by two methods with that of pathology was analyzed,to compare the diagnostic potency of MRI and ERUS in preoperative T staging of rectal cancer.Result In the surgery group,the accuracy of preoperative MRI T staging was 70.8%(17/24)with Kappa of 0.54(P<0.01)and the accuracy of ERUS T staging was 75.0%(18/24)with Kappa of 0.60(P<0.01).In the chemoradiotherapy group,the accuracy of preoperative MRI T staging was 57.9%(11/19)with Kappa of 0.40(P<0.01),and the accuracy of ERUS T staging was 36.8%(7/19)with Kappa of 0.15(P=0.15).Conclusion MRI and ERUS could accurately evaluate T staging of rectal cancer,but without accurate diagnosis of response of rectal cancer after chemoradiotherapy.

关 键 词：直肠癌 术前分期 MRI 直肠腔内超声 

分 类 号：R735.37[医药卫生—肿瘤]