中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2010年
7期
555-558
,共4页
俞耀军%卢明东%王飞海%孙维建%李丕宏%黄和%郑志强%林李淼%黄品同%程建敏%张海燕%谢作凯
俞耀軍%盧明東%王飛海%孫維建%李丕宏%黃和%鄭誌彊%林李淼%黃品同%程建敏%張海燕%謝作凱
유요군%로명동%왕비해%손유건%리비굉%황화%정지강%림리묘%황품동%정건민%장해연%사작개
胃肿瘤%腔内超声检查%肿瘤分期
胃腫瘤%腔內超聲檢查%腫瘤分期
위종류%강내초성검사%종류분기
Stomach neoplasms%Endosonography%Neoplasm staging
目的 在胃癌术前分期中,通过与超声内镜检查(EUS)对比分析超声双重造影(DCUS)检查的价值.方法 选择162例经病理活检证实为胃癌并进行手术切除的患者,手术前5 d内进行EUS及DCUS检查,并进行TNM分期,与术后病理检查结果对照得出正确率,并进行相互比较.结果 本组162例胃癌患者中TNM分期:42例为T1期,49例为T2期,56例为T3期,15例为T4期.DCUS和EUS术前T分期总的正确率分别为77.2%、74.7%(χ2=0.273,P=0.603),而在T3分期上DCUS优于EUS(χ2=5.009,P=0.025);在N分期上两者总的正确率分别为78.4%、57.4%(χ2=16.370,P=0.001),而两者的敏感性和特异性分别为78.4%比49.5%、78.5%比69.2%.在对阳性淋巴结诊断上DCUS的正确率较高(78.4%比49.5%,χ2=17.523,P<0.01),尤其是对低分化腺癌患者阳性淋巴结的诊断正确率较高(81.5%比42.6%,χ2=17.338,P<0.01).结论 DCUS检查在胃癌术前分期中有较好的应用价值,其在预测阳性淋巴结方面,尤其是判断低分化腺癌患者有无淋巴结转移上正确率高于EUS检查.
目的 在胃癌術前分期中,通過與超聲內鏡檢查(EUS)對比分析超聲雙重造影(DCUS)檢查的價值.方法 選擇162例經病理活檢證實為胃癌併進行手術切除的患者,手術前5 d內進行EUS及DCUS檢查,併進行TNM分期,與術後病理檢查結果對照得齣正確率,併進行相互比較.結果 本組162例胃癌患者中TNM分期:42例為T1期,49例為T2期,56例為T3期,15例為T4期.DCUS和EUS術前T分期總的正確率分彆為77.2%、74.7%(χ2=0.273,P=0.603),而在T3分期上DCUS優于EUS(χ2=5.009,P=0.025);在N分期上兩者總的正確率分彆為78.4%、57.4%(χ2=16.370,P=0.001),而兩者的敏感性和特異性分彆為78.4%比49.5%、78.5%比69.2%.在對暘性淋巴結診斷上DCUS的正確率較高(78.4%比49.5%,χ2=17.523,P<0.01),尤其是對低分化腺癌患者暘性淋巴結的診斷正確率較高(81.5%比42.6%,χ2=17.338,P<0.01).結論 DCUS檢查在胃癌術前分期中有較好的應用價值,其在預測暘性淋巴結方麵,尤其是判斷低分化腺癌患者有無淋巴結轉移上正確率高于EUS檢查.
목적 재위암술전분기중,통과여초성내경검사(EUS)대비분석초성쌍중조영(DCUS)검사적개치.방법 선택162례경병리활검증실위위암병진행수술절제적환자,수술전5 d내진행EUS급DCUS검사,병진행TNM분기,여술후병리검사결과대조득출정학솔,병진행상호비교.결과 본조162례위암환자중TNM분기:42례위T1기,49례위T2기,56례위T3기,15례위T4기.DCUS화EUS술전T분기총적정학솔분별위77.2%、74.7%(χ2=0.273,P=0.603),이재T3분기상DCUS우우EUS(χ2=5.009,P=0.025);재N분기상량자총적정학솔분별위78.4%、57.4%(χ2=16.370,P=0.001),이량자적민감성화특이성분별위78.4%비49.5%、78.5%비69.2%.재대양성림파결진단상DCUS적정학솔교고(78.4%비49.5%,χ2=17.523,P<0.01),우기시대저분화선암환자양성림파결적진단정학솔교고(81.5%비42.6%,χ2=17.338,P<0.01).결론 DCUS검사재위암술전분기중유교호적응용개치,기재예측양성림파결방면,우기시판단저분화선암환자유무림파결전이상정학솔고우EUS검사.
Objective To compare the accuracy of endoscopic ultrasound (EUS) with double contrast enhanced ultrasound ( DCUS) in the preoperative staging of gastric malignancies. Methods This study included 162 patients with biopsy proven gastric cancer who underwent surgical resection as primary management of their malignancies. All patients underwent DCUS and EUS prior to surgical intervention with the results of the ultrasound findings compared with the pathological stages of the resected specimen. Results Among the 162 gastric cancer patients, there were 42 cases of T1, 49 cases of T2, 56 cases of T3, and 15 cases of T4 tumors. The overall accuracy of DCUS and EUS for the determination of loco-regional tumor infiltration ( T Staging) was 77. 2% and 74. 7% , (χ2 = 0. 273, P = 0. 603). Comparison of ultrasound techniques revealed that DCUS was superior to EUS only for a tumor depth of T3 (χ2 =5. 009, P = 0.025). Lymph nodes were correctly staged with DCUS and EUS in 78.4% and 57. 4% of cases, respectively ( χ2 = 16. 370,P =0.001). Using DCUS, the sensitivity of the technique was 78. 4% with a specificity of 78. 5%. In comparison, EUS had a sensitivity of 49. 5% with a specificity of 69. 2%. DCUS also detected a higher incidence of positive lymph nodes than EUS for poorly differentiated (81. 5% vs. 42. 6% ,χ2 =17. 338, P < 0. 01) and overall tumor types (78.4% vs. 49. 5% , χ2 = 17.523, P < 0. 01). Conclusions Double contrast-enhanced ultrasonography offers another noninvasive approach for the preoperative evaluation of gastric cancer. DCUS was comparable to EUS in tumor depth evaluation. DCUS offers an advantage in the detection of lymph node metastases, especially in poorly differentiated tumors.
