腔内超声在直肠间质瘤诊断及新辅助治疗疗效评估中的应用价值  

Application of endorectal ultrasonography in rectal stromal tumor diagnosis and neoadjuvant therapy evaluation

作　　者：刘寒月[1] 郑渤[1] 陈月新[1] 石刚 LIU Hanyue;ZHENG Bo;CHEN Yuexin;SHI Gang(Department of Function,Huludao Central Hospital,Liaoning Huludao 125001,China;Department of Colorectal Surgery,Cancer Hospital of China Medical University,Liaoning Cancer Hospital ﹠Institute,Liaoning Shenyang 110042,China)

机构地区：[1]葫芦岛市中心医院功能科,辽宁葫芦岛125001 [2]中国医科大学肿瘤医院,辽宁省肿瘤医院结直肠外科,辽宁沈阳110042

出　　处：《现代肿瘤医学》2022年第4期697-700,共4页Journal of Modern Oncology

基　　金：辽宁省自然科学基金(编号:2019-MS-211)。

摘　　要：目的:评价腔内超声在直肠间质瘤诊断及新辅助治疗疗效评估中的应用价值,为直肠间质瘤临床诊断及疗效评估提供客观依据。方法:回顾性分析2015年05月至2020年05月我院46例直肠黏膜下肿瘤经直肠腔内超声进行鉴别诊断的患者,与病理诊断直肠间质瘤作为金标准进行直肠腔内超声诊断效能的验证。观察17例直肠间质瘤腔内超声参数,评价腔内超声对伊马替尼新辅助治疗的疗效评估价值,观察病理危险度与超声参数的关系。结果:直肠腔内超声诊断与病理诊断符合率为89.13%,灵敏度为88.24%,特异度为89.66%;直肠腔内超声显示,17例直肠间质瘤患者中,52.94%的肿瘤直径大于5 cm,76.47%的肿瘤为低回声,88.24%的肿瘤未发生囊性变,76.47%的肿瘤血运丰富,64.71%的肿瘤为向腔内生长型;直肠腔内超声对14例新辅助治疗患者进行评价,部分缓解57.14%(8/14),稳定42.86%(6/14),与治疗前比较,肿瘤直径减小(P<0.01),回声降低(P<0.05),囊性变增加(P<0.05),血流丰富程度降低(P<0.01)。肿瘤直径大,危险度高(P<0.01),肿瘤血运丰富,危险度高(P<0.05)。结论:直肠腔内超声在直肠间质瘤诊断中具有较高的灵敏度及特异度,可用于直肠间质瘤的鉴别诊断及新辅助治疗的疗效评估。Objective:To observe the value of endorectal ultrasonography in rectal stromal tumor diagnosis and neoadjuvant therapy evaluation.Methods:Forty-six patients form May 2015 to May 2020 diagnosed as submucosal tumor was differentiated by endorectal ultrasonography retrospectively.Pathological diagnosis was golden standard and the ultrasonic diagnosis efficiency was identified.Endorectal ultrasonic datas were observed in 17 rectal stromal patients and the value of endorectal ultrasonography in imatinib neoadjuvant therapy evaluation was identified.The relationship between pathological risk and ultrasonic datas was observed.Results:The coincidence rate,sensitivity and specialty of endorectal ultrasonography with pathological diagnosis was 89.13%,88.24%,89.66%respectively.Endorectal ultrasonography showed that 52.94%tumor was over 5 cm,76.47%tumor echo was low,88.24%tumor did not show cystic changes,76.47%tumor showed abundant vascular supply and 64.71%tumor showed intraluminal growth pattern.Neoadjuvant therapy reaction in 14 patients was evaluated with endorectal ultrasonography,partial response rate was 57.14%(8/14),stable disease rate was 42.86%(6/14).Compared with pre-therapy,tumor diameter decreased(P<0.01),tumor echo decreased(P<0.05),cystic change increased(P<0.05),abundance of blood flow decreased(P<0.01).The tumor was large in diameter and the risk was high(P<0.01).The blood supply of the tumor was rich and the risk was high(P<0.05).Conclusion:Endorectal ultrasonography possesses relatively high sensitivity and specialty,which can be used to carry on differential diagnosis and evaluate the neoadjuvant therapy reaction.

关 键 词：直肠间质瘤 直肠腔内超声 甲磺酸伊马替尼片 

分 类 号：R735.3[医药卫生—肿瘤]