术前超声内镜检查对胃癌患者T、N分期的诊断价值  

Diagnostic value of preoperative endoscopic ultrasonography in T and N staging of gastric cancer patients

作　　者：刘晓凌[1] 宋香谆[2] 闫岩 LIU Xiaoling;SONG Xiangzhun;YAN Yan(Endoscopy Room,Zhoukou Central Hospital,Zhoukou 466000,He’nan,China;Department of Gastroenterology,Jilin Provincial People’s Hospital,Changchun 130000,Jilin,China)

机构地区：[1]周口市中心医院内镜室,河南周口466000 [2]吉林省人民医院消化科,长春130000

出　　处：《癌症进展》2023年第13期1471-1474,共4页Oncology Progress

摘　　要：目的 探讨术前超声内镜(EUS)检查对胃癌患者T、N分期的诊断价值。方法 选取106例胃癌患者,术前均接受EUS检查,评估术前EUS检查与术前胃镜病理组织活检的诊断符合率;以术后病理学检查结果为金标准,评估术前EUS检查对胃癌患者T、N分期的诊断价值。结果 106例患者术前经EUS检查结果显示,胃癌最多发病变部位为胃窦(包括幽门),占比38.68%(41/106);BormannⅡ溃疡型最多,占比33.96%(36/106);低分化腺癌最多见,占比45.28%(48/106)。术前EUS检查诊断胃癌浆膜层浸润结果与胃镜病理组织活检结果比较的诊断符合率为100%(42/42),对胃癌肌层浸润的诊断符合率较低。以术后病理学检查结果为金标准,术前EUS检查诊断胃癌T分期的准确度为75.47%(80/106),其中T_(1)期的灵敏度最高,为83.33%(25/30),其次是T_(4)期,灵敏度为80.00%(12/15);且术前EUS检查诊断胃癌T分期的结果与病理检查结果的一致性一般(Kappa=0.697)。术前EUS检查诊断胃癌患者N分期的准确度为62.26%(66/106),其中N_(0)期的灵敏度最高,为90.91%(30/33),其次是N_(1)期,灵敏度为76.67%(23/30);且术前EUS检查诊断胃癌N分期的结果与病理检查结果的一致性一般(Kappa=0.511)。结论 术前EUS检查对胃癌患者T分期的诊断准确度较高,可作为胃癌患者术前T分期的首选检查方法;而对N分期诊断可结合其他影像学技术、穿刺活检等进行。Objective To investigate the diagnostic value of preoperative endoscopic ultrasonography(EUS)in T and N staging of gastric cancer patients.Method A total of 106 patients with gastric cancer were selected,all underwent EUS examination before the operation,and the diagnostic coincidence rate between preoperative EUS examination and preoperative gastroscopy pathological tissue biopsy was evaluated.The postoperative pathological examination results were used as the gold standard to evaluate the diagnostic value of preoperative EUS for T and N staging of gastric cancer patients.Result The preoperative EUS examination results of 106 patients showed that the most common lesion site of gastric cancer was the gastric antrum(including pylorus),accounting for 38.68%(41/106).Bormann II ulcer type was the most,accounting for 33.96%(36/106).Poorly differentiated adenocarcinoma was the most common,accounting for 45.28%(48/106).The diagnostic coincidence rate of preoperative EUS examination for serosal invasion of gastric cancer compared with gastroscopy pathological tissue biopsy results was 100%,while the diagnostic coincidence rate for gastric cancer muscle invasion was low.When taking the results of postoperative pathological examination as the gold standard,the accuracy of preoperative EUS in diagnosing the T stage of gastric cancer was 75.47%(80/106),and the sensitivity of T1 stage was the highest at 83.33%(25/30),followed by T4 stage with sensitivity of 80.00%(12/15).Moreover,the results of the preoperative EUS examination were consistent with the results of the pathological examination for the diagnosis of gastric cancer T staging at a normal level(Kappa=0.697).The accuracy of preoperative EUS in diagnosing gastric cancer N stage was 62.26%(66/106),and the sensitivity of N0 stage was the highest at 90.91%(30/33),followed by N1 stage with sensitivity of 76.67%(23/30).Moreover,the results of preoperative EUS examination for the diagnosis of gastric cancer N stage were consistent with the results of pathological examination

关 键 词：胃癌 超声内镜检查 临床分期 诊断价值 

分 类 号：R735.2[医药卫生—肿瘤]