超声内镜在食管癌术前分期中的诊断价值

发布时间：2018-03-06 03:30

本文选题：超声内镜　切入点：食管癌　出处：《皖南医学院》2014年硕士论文　论文类型：学位论文

【摘要】：目的：探讨超声内镜（Endoscopic ultrasonography,EUS）在食管癌的术前诊断和分期的临床价值。方法:收集经常规胃镜检查并病理诊断46例食管癌患者，术前再接受超声内镜检查，据此进行术前TNM分期。以术后病理为金标准，并与术后病理结果比较。结果:（1）食管癌术前EUS检查T分期的诊断准确率为71.7%，，其中T1期诊断的敏感性、特异性、准确性结果分别为60.0%、97.5%、93.4%；T2诊断的敏感性、特异性、准确性结果分别为66.7%、87.5%、84.7%；T3诊断的敏感性、特异性、准确性结果分别为78.5%、72.2%、76.1%；T4诊断的敏感性、特异性、准确性结果分别为57.1%、94.8%、89.1%。食管癌的术前EUS与术后病理各T分期组间均无显著性统计学差异（T1:P0.05；T2: P0.05；T3: P0.05；T4: P0.05）。（2）食管癌术前EUS检查N分期的诊断准确率为69.6%，其中NO期诊断的敏感性、特异性、准确性结果分别为80.0%、61.5%、69.6%，N1期诊断的敏感性、特异性、准确性结果分别为61.5%、80%、69.6%。食管癌的术前EUS与术后病理N分期各组间均无显著性统计学差异（NO：P＞0.05；N1：P＞0.05）。（3）食管癌术前EUS的T、N分期与术后病理的T、N分期的一致性均较好（0.4＜Kappa＜0.7）。结论:超声内镜对食管癌术前T分期诊断的准确率较高。对食管癌患者术前治疗策略的制定、手术方式的选择、术后预后的评估等方面具有一定的指导意义。
[Abstract]:Objective: to evaluate the clinical value of endoscopic ultrasonography (EUS) in preoperative diagnosis and staging of esophageal carcinoma. Methods: 46 patients with esophageal carcinoma were examined by conventional gastroscopy and pathologically, and then underwent endoscopic ultrasonography before operation. According to the preoperative TNM staging, the postoperative pathology was taken as the gold standard, and the results were compared with the postoperative pathological results. Results the diagnostic accuracy of T staging by EUS before operation was 71.7. The sensitivity, specificity and accuracy of T _ 1 stage were 60.097. 5% and 93. 4% respectively. The diagnostic sensitivity, specificity and accuracy of T _ 2 were 66.7% and 87.5% respectively, and the sensitivity, specificity and accuracy of T _ 3 were 66.7%, 87.5% and 84.7%, respectively. The sensitivity, specificity and accuracy of the diagnosis of T4 were 57.1% and 94.8%, respectively. There was no significant statistical difference between the preoperative EUS of esophageal carcinoma and the postoperative pathological T staging groups (T1: P0.05T2: P0.05T3: P0.05T4: P0.05T4: P0.05T4: P0.05T4: P0.05T4: P0.05T4: P0.05T4: P0.05T4: P0.05T4: P0.05T4: P0.05T4: P0.05T4: P0.05T4: P0.05T4: P0.05T4 respectively. (2) the diagnostic accuracy of N staging in preoperative EUS examination of esophageal carcinoma was 69.6, and the sensitivity, specificity and accuracy of no stage diagnosis were 80.0% and 61.5%, respectively, and the sensitivity and specificity of the diagnosis of N _ 1 stage were 80.0%, 61.5% and 69.66%, respectively. There was no significant difference between preoperative EUS and postoperative pathological N staging of esophageal carcinoma (P > 0.05 N 1: P > 0.05% P > 0.05). (3) the consistency of EUS staging before and after operation was better than that with pathological staging (0.4 < Kappa < 0.7) in esophageal carcinoma. Conclusion: the accuracy of endoscopic ultrasonography in the diagnosis of preoperative T staging of esophageal cancer is high, and it has certain guiding significance in the formulation of preoperative treatment strategy, the choice of surgical methods and the evaluation of postoperative prognosis in patients with esophageal cancer.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R735.1

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