超声内镜诊断食管癌浸润深度的准确性及影响因素分析  

Diagnostic accuracy of ultrasound endoscope for esophageal cancer infiltration depth and its influencing factors

作　　者：付鑫[1] 胡炳德[1] 梁丁保[1] Fu Xin;Hu Bingde;Liang Dingbao(Department of Gastroenterology,Anqing Hospital of Chinese Navy,Anqing 246001,China)

机构地区：[1]海军安庆医院消化科,安徽安庆246001

出　　处：《海军医学杂志》2022年第8期836-840,共5页Journal of Navy Medicine

摘　　要：目的探究超声内镜诊断食管癌浸润深度的准确性并分析其影响因素。方法回顾性分析海军安庆医院2015年6月至2019年7月收治的60例食管癌患者的临床资料,了解患者治疗前接受超声内镜检查判断肿瘤浸润程度的情况,并与手术病理浸润深度判断结果进行比较,分析采用超声内镜判断食管癌浸润深度准确性的影响因素。结果术前超声内镜诊断食管癌M1~M2、M3~SM1、SM2~SM3浸润深度分别有11例(18.33%)、41例(68.33%)以及8例(13.33%),术后病理检查诊断食管癌M1~M2、M3~SM1、SM2~SM3浸润深度分别有12例(20.00%)、45例(75.00%)以及3例(5.00%);以病理检查结果为金标准,超声内镜诊断食管癌M1~M2、M3~SM1、SM2~SM3浸润深度准确度分别为81.67%、90.00%以及91.67%,与病理检查结果一致性Kappa值分别为0.409、0.755以及0.510;食管癌患者性别、肿瘤深度、病灶位置、淋巴结清扫站数与浸润深度诊断准确性不相关(P>0.05),而食管癌患者年龄、肿瘤尺寸、大体分型、分化程度与浸润深度诊断准确性存在相关性(P<0.05);多因素分析结果显示,年龄≤55岁以及大体分型不是超声内镜浸润深度诊断准确性的独立影响因素(P>0.05),而肿瘤尺寸>2 cm以及肿瘤分化是超声内镜浸润深度诊断准确性的独立影响因素(P<0.05)。结论超声内镜诊断食管癌浸润深度准确性较高,而肿瘤尺寸以及分化情况均会影响浸润深度诊断准确性。Objective To explore the diagnostic accuracy of ultrasound endoscopy(UE)for esophageal cancer infiltration lepth,and also to analyze factors affecting accuracy.Methods A retrospective analysis was performed on the data of 60 patients with esophageal cancer who were treated in the hospital from June 2015 to July 2019.Before treatment,the patients underwent UE to deect tumor infiltration depths,and they were compared with the depths revealed by surgical method.UE was applied to analyze factors affecting accuracy of esophageal cancer infiltration depths.Results Before surgery,UE diagnosis showed there were respectively 11 cases(18.33%),41 cases(68.33%)and 8 cases(13.33%)with esophageal cancer infiltration depths at M1-M2,M3-SM1 and SM2-SM3.Postoperative pathological examination showed there were 12 cases(20.00%),45 cases(75.00%)and 3 cases(5.00%)at M1-M2,M3-SM1 and SM2-SM3,respectively.Taking pathological examination results as a golden standard,the accutacy rates of UE for the diagnosis of esophageal cancer infiltration depths at M1-M2,M3-SM1 and SM2-SM3 were respectively81.67%,90.00%and 91.67%.The consistencies with pathological examination results were 0.409,0.755 and 0.510,respectivey.Gender,tumor depth,lesion locations and number of lymph node dissections in esophageal cancer patients were not correlated vith diagnostic accuracy of infiltration depths(P>0.05),while age,tumor size,gross typing and differentiation degree were correlated with the accuracy of infiltration depths(P<0.05).Multivariate analysis showed that age(not older than 55 years)and general typing were not independent factors affecting diagnostic accuracy of infiltration depths by UE(P>0.05),while tumor sizes larger than2 cm and tumor differentiation were independent influencing factors(P<0.05).Conclusion UE displayed a relatively high diagnostic accuracy of esophageal cancer infiltration depths.The tumor size and differentiation degree could affect diagnostic accuracy of infiltration depths.

关 键 词：超声内镜 食管癌 浸润深度 准确性 影响因素 

分 类 号：R445.1[医药卫生—影像医学与核医学]