微探头超声内镜在直肠癌术前分期中的价值
发布时间：2018-09-17 17:09
【摘要】：目的：探讨微探头超声内镜(MUP)在直肠癌术前TNM分期中的价值。 方法：对71例手术切除的直肠癌患者术前行12MHz MUP检查,收集所有超声图像后由同一名内镜超声医师根据UICC最新第7版直肠癌TNM分期指南进行TN分期,并与术后病理结果进行回顾性比较。 结果：12MHz MUP对71例直肠癌T分期的总符合率为72%(51/71),其中各期诊断准确率为T182%, T276%, T390%, T495%。MUP对直肠癌T分期的敏感度和特异度分别为T1(早期直肠癌)46%、100%,T292%、68%,T378%、93%,T478%、98%。T分期过高及不足分别为21%(15/71)及7%(5/71)。MUP对直肠癌N分期符合率为73%(52/71),N分期的准确度,敏感度和特异度分别为NO73%、93%、12%,N183%、20%、93%,N290%、0、100%。N分期过度及分期不足分别为6%(4/71)和21%(15/71)。MUP对直肠上段(距肛门12cm)、中段(7-12cm)及下段(0-6cm)直肠癌T分期诊断符合率分别为100%、74%、68%,三组间两两符合率无统计学差异(P0.05),直肠下段及直肠中上段的符合率差异也无统计学意义(P0.05)。肿瘤直径大于2cm组相比小于2cm组诊断符合率较低(57%vs73%),但差异无统计学意义(P0.05)。 结论：MUP对直肠癌术前TN分期有较高价值,尤其是对早期直肠癌(T1)的特异度很高,但对N+的诊断敏感度有待进一步提高。提高临床医师水平、在病灶体积较大及淋巴结探查时选择穿透性更强频率较低的标准镜,必要时结合EUS-FNA等技术可以提高EUS对直肠癌术前分期的水平。
[Abstract]:Objective: to evaluate the value of microprobe endoscopic (MUP) in preoperative TNM staging of rectal cancer. Methods: 12MHz MUP was performed in 71 patients with rectal cancer before operation. After all ultrasound images were collected, TN staging was performed by the same endoscopic ultrasound physician according to the latest TNM staging guidelines for rectal cancer in the seventh edition of UICC. A retrospective comparison was made between the pathological results and postoperative pathological results. Results the overall coincidence rate of MUP was 72% (51 / 71) for 71 cases of rectal cancer T staging, in which the accuracy rate was T1822, T276, T390. the sensitivity and specificity of T495%.MUP for T staging of rectal cancer were T 1 (early rectal cancer) 46268T 378N 933T 478M 93T 478U 98.T was too high and insufficient, respectively. The accuracy of 21% (15 / 71) and 7% (5 / 71). MUP for N staging of rectal cancer was 73% (52 / 71). The sensitivity and specificity of NO73%,93%,12%,N183%,20%,93%,N290%,0100%.N staging were 6% (4 / 71) and 21% (15 / 71) respectively. The coincidence rates of T staging in upper rectal segment (12cm), middle segment (7-12cm) and lower segment (0-6cm) were 100% and 74%, respectively. There was no significant difference between the three groups. There was no significant difference in the coincidence rate between the lower rectum and the middle and upper rectum (P0.05). The diagnostic coincidence rate of tumor diameter larger than that of 2cm group was lower than that of 2cm group (57 vs 73%), but the difference was not statistically significant (P0.05). Conclusion the TN staging of rectal cancer is of high value, especially the specificity of early rectal cancer (T1), but the sensitivity to N diagnosis needs to be further improved. In order to improve the clinician's level, select the standard mirror with higher penetration frequency when the focus is larger and lymph node exploration, if necessary, combined with EUS-FNA and other techniques, we can improve the level of preoperative staging of rectal cancer by EUS.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R735.37
[Abstract]:Objective: to evaluate the value of microprobe endoscopic (MUP) in preoperative TNM staging of rectal cancer. Methods: 12MHz MUP was performed in 71 patients with rectal cancer before operation. After all ultrasound images were collected, TN staging was performed by the same endoscopic ultrasound physician according to the latest TNM staging guidelines for rectal cancer in the seventh edition of UICC. A retrospective comparison was made between the pathological results and postoperative pathological results. Results the overall coincidence rate of MUP was 72% (51 / 71) for 71 cases of rectal cancer T staging, in which the accuracy rate was T1822, T276, T390. the sensitivity and specificity of T495%.MUP for T staging of rectal cancer were T 1 (early rectal cancer) 46268T 378N 933T 478M 93T 478U 98.T was too high and insufficient, respectively. The accuracy of 21% (15 / 71) and 7% (5 / 71). MUP for N staging of rectal cancer was 73% (52 / 71). The sensitivity and specificity of NO73%,93%,12%,N183%,20%,93%,N290%,0100%.N staging were 6% (4 / 71) and 21% (15 / 71) respectively. The coincidence rates of T staging in upper rectal segment (12cm), middle segment (7-12cm) and lower segment (0-6cm) were 100% and 74%, respectively. There was no significant difference between the three groups. There was no significant difference in the coincidence rate between the lower rectum and the middle and upper rectum (P0.05). The diagnostic coincidence rate of tumor diameter larger than that of 2cm group was lower than that of 2cm group (57 vs 73%), but the difference was not statistically significant (P0.05). Conclusion the TN staging of rectal cancer is of high value, especially the specificity of early rectal cancer (T1), but the sensitivity to N diagnosis needs to be further improved. In order to improve the clinician's level, select the standard mirror with higher penetration frequency when the focus is larger and lymph node exploration, if necessary, combined with EUS-FNA and other techniques, we can improve the level of preoperative staging of rectal cancer by EUS.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R735.37
【参考文献】
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1 王军;陈东风;李平;彭安国;刘重阳;;超声内镜对直肠癌诊断和分期的价值[J];重庆医学;2009年04期
2 彭海霞;褚以_，
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