小探头超声与白光胃镜对早期胃癌黏膜下浸润预测价值的比较  

Comparison of the Predictive Value of Miniprobe Endoscopic Ultrasonography and White Light Endoscopy for Submucosal Invasion of Early Gastric Cancer

作　　者：张舒 胡祥鹏[1] 周建梅 陶莉[1] 李慧 朱元荣 ZHANG Shu;HU Xiang-peng;ZHOU Jian-mei;TAO Li;LI Hui;ZHU Yuan-rong(Department of Digestive Medicine,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,Anhui,China)

机构地区：[1]安徽医科大学第二附属医院消化内科,安徽合肥230601

出　　处：《医学信息》2022年第14期49-52,共4页Journal of Medical Information

基　　金：安徽医科大学校科研基金(编号:2020xkj205);安徽医科大学第二附属医院博士研究基金(编号:2018BSJJ054);安徽高校自然科学研究重点项目(编号:KJ2019A0268);2021年高校优秀拔尖人才培育资助项目(编号:gxgwfx2021012)。

摘　　要：目的比较小探头超声(mEUS)与白光胃镜对早期胃癌(EGC)有无黏膜下(SM)浸润的预测价值,分析影响mEUS预测EGC有无SM浸润准确性的因素。方法回顾性分析2018年3月-2021年6月在安徽医科大学第二附属医院经术后病理确诊为EGC的患者临床资料,将术前白光胃镜和mEUS资料完整的39例患者纳入研究,将白光胃镜、mEUS及病理诊断的浸润深度分为无SM浸润(<T1b),有SM浸润或更深(≥T1b)。以术后病理为诊断金标准,比较白光胃镜、mEUS预测EGC有无SM浸润的准确性,分析影响mEUS预测EGC有无SM浸润的准确性的影响因素。结果mEUS预测EGC有无SM浸润的准确性高于白光胃镜(76.92%vs 74.36%),但差异无统计学意义(P>0.05);mEUS预测EGC有无SM浸润的敏感度、特异度、阳性预测值、阴性预测值、Kappa值、AUC分别是69.23%、80.77%、64.29%、84.00%、0.491、0.750,白光胃镜分别为69.23%、73.08%、56.25%、82.60%、0.400、0.712,单因素分显示,当EGC伴有溃疡、组织病理类型呈未分化型时,mEUS诊断EGC有无SM浸润的准确性下降,差异有统计学意义(P<0.05);不同年龄、性别、肿瘤位置、肿瘤大小比较,mEUS诊断EGC有无SM浸润的准确性比较,差异无统计学意义(P>0.05);mEUS预测溃疡型病灶过度分期多于分期不足,而病灶位于上1/3病灶少于分期不足,差异有统计学意义(P<0.05)。结论白光胃镜与mEUS在预测EGC有无SM浸润准确性相似,溃疡型EGC及未分化型EGC影响mEUS诊断EGC有无SM浸润的准确性。Objective To compare the predictive value of miniprobe endoscopic ultrasonography(mEUS)and white light endoscopy in predicting the presence or absence ofsubmucosal(SM)invasion in early gastric cancer(EGC),and to analyze the factors affecting the accuracy of mEUS in predictingthe presence or absence of SM invasion in EGC.Methods The clinical data of 39 patients with EGC diagnosed by postoperative pathology in the Second Affiliated Hospital of Anhui Medical University from March 2018 to June 2021 were retrospectively analyzed.39 patients with complete preoperative white light endoscopy and mEUS data were included in the study.The infiltration depth of white light endoscopy,mEUS and pathological diagnosis was divided into no SM infiltration(<T1b)and SM infiltration or deeper(≥T1b).Taking postoperative pathology as the diagnostic gold standard,the accuracy of white light endoscopy and mEUS in predicting SM infiltration in EGC was compared,and the influencing factors affecting the accuracy of mEUS in predicting SM infiltration in EGC were analyzed.Results The accuracy of mEUS in predicting SM infiltration in EGC was higher than that in white light gastroscope(76.92%vs 74.36%),but the difference was not statistically significant(P>0.05).The sensitivity,specificity,positive predictive value,negative predictive value,Kappa value and AUC of mEUS for predicting SM infiltration in EGC were 69.23%,80.77%,64.29%,84.00%,0.491 and 0.750,respectively,and those of white light endoscopywere 69.23%,73.08%,56.25%,82.60%,0.400 and 0.712.Single factor analysis showed that the accuracy of mEUS in the diagnosis of SM infiltration in EGC decreased when EGC was accompanied by ulcer and undifferentiated histopathological type,and the difference was statistically significant(P<0.05).There was no significant difference in the accuracy of mEUS in the diagnosis of SM infiltration in EGC among different age,gender,tumor location and tumor size(P>0.05).The mEUS predicted that the excessive staging of ulcerative lesions was more than that of in

关 键 词：小探头超声 白光胃镜 黏膜下浸润 早期胃癌 

分 类 号：R735.2[医药卫生—肿瘤] R445.1[医药卫生—临床医学]