肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2011年
11期
765-767
,共3页
庞尔国%池澈%杨智文%张丙钊
龐爾國%池澈%楊智文%張丙釗
방이국%지철%양지문%장병쇠
直肠肿瘤%腔内超声检查%癌胚抗原%肿瘤分期
直腸腫瘤%腔內超聲檢查%癌胚抗原%腫瘤分期
직장종류%강내초성검사%암배항원%종류분기
Rectal neoplasms%Endosonography%Carcinoembrynonic antigen%Neoplasms staging
目的 研究直肠腔内超声( TRUS)联合癌胚抗原(CEA)检查对直肠癌术前TNM分期和术后病理pTNM分期诊断的一致性.方法 将病理证实的118例直肠癌患者按随机数字表法分为术前行单独TRUS检查组和TRUS联合血清CEA检查组各59例,回顾性分析两组术前分期与术后病理分期结果的一致性.结果 TRUS联合CEA组的术前T分期与术后病理诊断一致47例,准确度为79.7％,术前N分期与术后病理诊断一致42例,准确度为77.8％.而TRUS组术前T分期与术后病理诊断一致51例,准确度为86.4％,术前N分期与术后病理诊断一致30例,准确度为57.7％.与术后病理T、N分期一致性检验显示,直肠癌术前TRUS联合CEA组T、N分期与术后病理T、N分期有较好一致性(κ=0.685,0.544,均P=0.000),而TRUS组中T分期一致性较好(κ=0.755,P=0.000),N分期一致性较差(κ =0.154,P=0.229).结论 TRUS联合CEA检查术前评估直肠癌可提高术前分期的准确性,为手术决策提供依据,提高手术方案预测的符合率,为直肠癌术前精准诊断和个体化治疗提供依据.
目的 研究直腸腔內超聲( TRUS)聯閤癌胚抗原(CEA)檢查對直腸癌術前TNM分期和術後病理pTNM分期診斷的一緻性.方法 將病理證實的118例直腸癌患者按隨機數字錶法分為術前行單獨TRUS檢查組和TRUS聯閤血清CEA檢查組各59例,迴顧性分析兩組術前分期與術後病理分期結果的一緻性.結果 TRUS聯閤CEA組的術前T分期與術後病理診斷一緻47例,準確度為79.7％,術前N分期與術後病理診斷一緻42例,準確度為77.8％.而TRUS組術前T分期與術後病理診斷一緻51例,準確度為86.4％,術前N分期與術後病理診斷一緻30例,準確度為57.7％.與術後病理T、N分期一緻性檢驗顯示,直腸癌術前TRUS聯閤CEA組T、N分期與術後病理T、N分期有較好一緻性(κ=0.685,0.544,均P=0.000),而TRUS組中T分期一緻性較好(κ=0.755,P=0.000),N分期一緻性較差(κ =0.154,P=0.229).結論 TRUS聯閤CEA檢查術前評估直腸癌可提高術前分期的準確性,為手術決策提供依據,提高手術方案預測的符閤率,為直腸癌術前精準診斷和箇體化治療提供依據.
목적 연구직장강내초성( TRUS)연합암배항원(CEA)검사대직장암술전TNM분기화술후병리pTNM분기진단적일치성.방법 장병리증실적118례직장암환자안수궤수자표법분위술전행단독TRUS검사조화TRUS연합혈청CEA검사조각59례,회고성분석량조술전분기여술후병리분기결과적일치성.결과 TRUS연합CEA조적술전T분기여술후병리진단일치47례,준학도위79.7％,술전N분기여술후병리진단일치42례,준학도위77.8％.이TRUS조술전T분기여술후병리진단일치51례,준학도위86.4％,술전N분기여술후병리진단일치30례,준학도위57.7％.여술후병리T、N분기일치성검험현시,직장암술전TRUS연합CEA조T、N분기여술후병리T、N분기유교호일치성(κ=0.685,0.544,균P=0.000),이TRUS조중T분기일치성교호(κ=0.755,P=0.000),N분기일치성교차(κ =0.154,P=0.229).결론 TRUS연합CEA검사술전평고직장암가제고술전분기적준학성,위수술결책제공의거,제고수술방안예측적부합솔,위직장암술전정준진단화개체화치료제공의거.
Objective To study the consistency of preoperative staging by transrectal ultrasonography (TRUS) combined with serum carcinoembryonic antigen (CEA) and the postoperative pathological TNM staging (PTNM).Methods 118 rectal cancer patients pathologically proven were divided into preoperative TRUS combined with CEA group (59 cases) and along TRUS group (59 cases).The consistency of preoperative stag in 2 groups and postoperative pathological stage was analyzed retrospectively.Results In TRUS combined with CEA group,the accuracy of T stage was 79.7 ％ (47/59),and the accuracy of N stage was 77.8 ％ (42/59),compared with the postoperative pTNM.While in along TRUS group,the accuracy of T stage was 86.4 ％ (51/59),and the accuracy of N stage was 57.7 ％ (30/59).The consistencies of T and N stage in TRUS combined with CEA group and postoperative pTNM were better (κ =0.685,P =0.000; κ =0.544,P =0.000).While the consistency of T stage in along TRUS and postoperative pTNM was better (κ =0.755,P =0.000),but that of N stage was poor (κ =0.154,P =0.229).Conclusion Preoperative evaluation by the TRUS combined with CEA can increase the accuracy of preoperative stage which can provide more reliable basis for decision-making and improve the rate of coincidence of operative procedures in line with forecasts.At the same time,it can provide the basis for the accurate preoperative diagnosis and individualized treatment.
