CAJ | 학술논문

目的评价微探头超声联合环扫内镜超声检查对直肠癌术前分期的特异性、敏感性和准确性以及判断其对直肠癌治疗方案选择的价值.方法对2007年8月-2008年8月60例术前直肠癌患者行微探头和环扫超声内镜联合探查.参照TNM分期标准进行分期诊断,并与MRI、手术后组织病理学结果对比,总结EUS分期对治疗方案选择的参考价值.结果在60例直肠癌患者中,EUS分期T1期4例,T2期18例,T3期30例,T4期8例,存在7例分期过度和4例分期不足;MRI分期T1期1例,T2期18例,T3期30例,T4期10例,存在14例分期过度和3例分期不足.微探头超声内镜结合环扫型超声内镜对直肠癌T分期诊断综合准确率为81.67%(49/60),N分期的准确率为78.33%,敏感性和特异性为71.43%和91.03%;MRI对直肠癌T分期准确率为71.67%(43/60),周围淋巴结转移诊断的准确率为83.33%,敏感性和特异性为85.71%和86.96%.结论微探头联合环扫内镜超声检查是一有效估计直肠癌肠壁浸润深度并对其进行TN分期的方法,且操作简便、痛苦小、诊断准确率较高.
목적 평개미탐두초성연합배소내경초성검사대직장암술전분기적특이성、민감성화준학성이급판단기대직장암치료방안선택적개치.방법 대2007년8월-2008년8월60례술전직장암환자행미탐두화배소초성내경연합탐사.삼조TNM분기표준진행분기진단,병여MRI、수술후조직병이학결과대비,총결EUS분기대치료방안선택적삼고개치.결과 재60례직장암환자중,EUS분기T1기4례,T2기18례,T3기30례,T4기8례,존재7례분기과도화4례분기불족;MRI분기T1기1례,T2기18례,T3기30례,T4기10례,존재14례분기과도화3례분기불족.미탐두초성내경결합배소형초성내경대직장암T분기진단종합준학솔위81.67%(49/60),N분기적준학솔위78.33%,민감성화특이성위71.43%화91.03%;MRI대직장암T분기준학솔위71.67%(43/60),주위림파결전이진단적준학솔위83.33%,민감성화특이성위85.71%화86.96%.결론 미탐두연합배소내경초성검사시일유효고계직장암장벽침윤심도병대기진행TN분기적방법,차조작간편、통고소、진단준학솔교고.
Objective To evaluate the specificity,sensitivity and accuracy of miniature probe combined with radial scanning endoscopic ultrasonography(EUS)in preoperative TN staging of rectal cancer,and to assess its value in the choice of therapeutic strategy.Methods A total of 60 patients with rectal cancer received EUS assessment before surgery.Diagnosis was made according to TNM standard and compared with those of MRI and postoperative pathological examination.The reference value of EUS for therapy selection was studied.Results According to EUS staging,there were 4 cases of TI,18 T2,30 T3 and 8 T4,among which 7 cases were over-staged and 4 others were under-staged.MRI staging showed 1 case of T1,18 T2,30 T3 and 10 T4,among which 14 were over-staged and 3 others were under-staged.The total accuracy of EUS in T staging and N staging was 81.67%(49/60)and 78.33%,respectively,with the sensitivity and specificity at 71.43%and 91.03%,respectively.Accuracy of MRI for T staging and N staging were 71.67%(43/60)and 83.33%,respectively,with the sensitivity and specificity as 85.71%and 86.96%.Conclusion EUS with combination of miniature probe and radial scanning is effective in preoperative TN staging of rectal cancer with easy manipulation and less pain.