经腹超声检查对大肠癌的诊断价值  

Diagnostic Value of Transabdominal Ultrasonography in Colorectal Cancer

作　　者：李海莹 张丹丹 于士芳 姜晓龙[1] 谢丹[1] 范洁[1] 朱红[1] LI Haiying;ZHANG Dandan;YU Shifang;JIANG Xiaolong;XIE Dan;FAN Jie;ZHU Hong(Department of Physical Diagnostics,Heilongjiang Provincial Hospital,Harbin Heilongjiang 150036,China)

机构地区：[1]黑龙江省医院物理诊断科,黑龙江哈尔滨150036

出　　处：《中国卫生标准管理》2023年第1期118-123,共6页China Health Standard Management

摘　　要：目的探讨经腹超声检查对大肠癌的诊断价值。方法收集黑龙江省医院2010年1月—2020年4月收治的80例疑似大肠癌患者的影像与临床资料,患者术前均行腹部超声检查,将超声诊断与肠镜检查和(或)术后病理诊断结果对比。结果80例疑似大肠癌患者中,69例经肠镜及病理学检查确诊为大肠癌。超声诊断的准确率为91.3%(73/80),与病理诊断相比,提示诊断中等一致性(Kappa=0.544,95%CI 0.250~0.838,P<0.001),灵敏度为98.6%(68/69),特异度为45.5%(5/11),阳性预测值为91.9%(68/74),阴性预测值为83.3%(5/6)。49例患者手术病理证实为大肠癌,对比分析超声T分期与手术病理学分期诊断准确率,T分期的总诊断准确率为89.8%(44/49),提示诊断中等一致性(Kappa=0.395,95%CI-0.024~0.814,P=0.003),计算T3、T4灵敏度为66.7%(2/3)、91.3%(42/46),特异度为91.3%(42/46)、66.7%(2/3),阳性预测值为33.3%(2/6)、97.7%(42/43),阴性预测值为97.7%(42/43)、33.3%(2/6)。单因素分析中,肿瘤及患者临床指标对肿瘤分期无影响。超声诊断转移性淋巴结的诊断准确性为55.1%(27/49),提示诊断结果一致性极低(Kappa=0.013,95%CI-0.224~0.250,P=0.915)。结论经腹超声可用来诊断大肠癌及肿瘤分期,对于不适宜肠镜检查者,超声可为大肠癌患者提供一种新的评估方法。Objective To evaluate the diagnostic value of transabdominal ultrasonography in colorectal cancer.Methods The imaging and clinical data of 80 patients with suspected colorectal cancer were collected in Heilongjiang Provincial Hospital from January 2010 to April 2020.All patients underwent abdominal ultrasound examination before surgery.The ultrasound diagnosis was compared with the results of electronic colonoscopy and/or postoperative pathological diagnosis.Results Among the 80 suspected colorectal cancer patients,69 case swerediag nosed with co lorectal cancer by colonoscopy and pathological examination.The accuracy rate of ultrasonic diagnosis was 91.3%(73/80).Compared with pathological diagnosis,it suggested moderate diagnostic consistency(Kappa=0.544,95%CI 0.250~0.838,P<0.001),The sensitivity was 98.6%(68/69),the specificity was 45.5%(5/11),the positive predictive value was 91.9%(68/74)and the negative predictive value was 83.3%(5/6).49 patients were pathologically confirmed to be colorectal cancer,and the diagnostic accuracy of ultrasound T staging was compared with that of surgical pathology staging.The overall diagnostic accuracy of T staging was 89.8%(44/49),suggesting a medium diagnostic consistency(Kappa=0.395,95%CI-0.024~0.814,P=0.003),The sensitivity of T3 and T4 was 66.7%(2/3)and 91.3%(42/46),the specificity was 91.3%(42/46)and 66.7%(2/3),the positive predictive value was 33.3%(2/6)and 97.7%(42/43),and the negative predictive value was 97.7%(42/43)and 33.3%(2/6).In univariate analysis,tumor and patient clinical indicators had no effect on tumor stage.The diagnostic accuracy of ultrasound to metastatic lymph nodes was 55.1%(27/49),suggesting very low diagnostic consistency(Kappa=0.013,95%CI-0.224~0.250,P=0.915).Conclusion Transabdominal ultrasound can be used in the diagnosis of colorectal cancer and tumor staging,ultrasound may provide a new evaluation method for colorectal cancer patients who are not suitable for colonoscopy.

关 键 词：经腹超声 大肠癌 术前T分期 肠壁层次 淋巴结转移 诊断价值 

分 类 号：R445[医药卫生—影像医学与核医学]