体表超声在老年原发性胃癌分期诊断及术前评价中的价值

发布时间：2018-11-12 20:05

【摘要】：目的分析体表超声在老年原发性胃癌中的分期诊断价值及术前评价效果,为临床诊断与手术治疗提供参考依据。方法选取经胃镜活检确诊为原发性胃癌的老年患者100例。所有患者术前分别采用体表超声和内镜超声进行检测,并与手术病理组织学检验结果进行对照。结果体表超声与内镜超声在胃癌浸润深度T分期检验的准确率分别为67.6%和69.5%,两组间无统计学差异(P0.05),其中体表超声与内镜超声T1准确率分别为54.5%和68.1%、T2准确率分别为52.4%和57.1%、T3准确率分别为77.1%和80.0%、T4准确率分别为86.4%和72.7%,内镜超声T1准确率显著高于体表超声(P0.05),体表超声T4准确率显著高于内镜超声(P0.05),但体表超声与内镜超声在T2、T3准确率差异无统计学意义;体表超声与内镜超声在胃癌术前N分期检验的准确率分别为82.2%和48.8%,两组间有统计学差异(P0.05),其中体表超声与内镜超声N0准确率分别为72.0%和92.0%、N1准确率分别为80.0%和48.0%、N2准确率分别为86.7%和30.0%、N3准确率分别为90.0%和25.0%,体表超声在N1、N2、N3分期的准确率均高于内镜超声(P0.05),但内镜超声N0分期准确率显著高于体表超声(P0.05);体表超声与内镜超声在胃癌术前M分期检验的准确率分别为90.0%和29.2%,两组间有统计学差异(P0.05),其中体表超声与内镜超声M0准确率分别为100.0%和28.3%、M1准确率分别为80.0%和30.0%,体表超声M0、M1分期准确率均显著高于内镜超声(P0.05)。结论体表超声和内镜超声在原发性胃癌中均有较好的分期诊断价值,但体表超声检查的应用价值显著高于内镜超声,具有操作便捷且经济实惠的优势,并且能够反复使用,患者对其接受度较高,在术前胃癌分期诊断中具有更好的应用效果。
[Abstract]:Objective to analyze the diagnostic value and preoperative evaluation of body surface ultrasound in elderly patients with primary gastric cancer, and to provide reference for clinical diagnosis and surgical treatment. Methods 100 elderly patients with primary gastric cancer diagnosed by gastroscopy were selected. All patients were examined by body surface ultrasound and endoscopic ultrasonography before operation and compared with the results of histopathological examination. Results the accuracy of body surface ultrasound and endoscopic ultrasonography in T staging of invasive depth of gastric cancer was 67.6% and 69.5%, respectively. There was no significant difference between the two groups (P0.05). The accuracy rate of body surface ultrasound and endoscopic ultrasonography was 54.5% and 68.1% respectively, and the accuracy rate of T _ 2 was 52.4% and 57.1%, respectively, and the accuracy of T _ 3 was 77.1% and 80.0%, respectively. The accuracy rate of T4 was 86.4% and 72.7%, respectively. The accuracy of endoscopic ultrasound T 1 was significantly higher than that of body surface ultrasound (P0.05), the accuracy of body surface ultrasound T 4 was significantly higher than that of endoscopic ultrasound (P0.05), but the accuracy of body surface ultrasound and endoscope ultrasound was significantly higher than that of endoscopic ultrasound (P0.05). There was no significant difference in T3 accuracy. The accuracy of body surface ultrasound and endoscopic ultrasonography in preoperative N staging of gastric cancer was 82.2% and 48.8% respectively, and there was significant difference between the two groups (P0.05). The accuracy of body surface ultrasound and endoscopic ultrasound N0 was 72.0% and 92.0% respectively. The accuracy rate of N1 was 80.0% and 48.0% respectively, and the accuracy of N2 was 86.7% and 30.0%, respectively. The accuracy of N3 staging was 90.0% and 25.0%, respectively. The accuracy of body surface ultrasound in N1N2N3 staging was higher than that of endoscopic ultrasound (P0.05), but the accuracy of endoscopic ultrasound N0 staging was significantly higher than that of body surface ultrasound (P0.05). The accuracy rate of body surface ultrasound and endoscopic ultrasonography in preoperative M staging of gastric cancer was 90.0% and 29.2%, respectively. There was statistical difference between the two groups (P0.05). The accuracy rates of body surface ultrasound and endoscopic ultrasound M0 were 100.0% and 28.3M, respectively. The accuracy of body surface ultrasound M0M 1 staging was significantly higher than that of endoscopic ultrasound (P0.05). Conclusion both body surface ultrasound and endoscopic ultrasound have good diagnostic value in staging of primary gastric cancer, but the application value of body surface ultrasound is significantly higher than that of endoscopic ultrasound, which has the advantages of convenient and economical operation, and can be used repeatedly. The patients have higher acceptance and better results in preoperative diagnosis of gastric cancer staging.
【作者单位】： 济源市人民医院超声科;济源市妇幼保健院;宁夏医科大学;
【基金】：国家自然科学基金项目支持(No.81560769)
【分类号】：R445.1;R735.2
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本文编号：2328082