超声内镜在直肠癌术前TN分期中的价值

发布时间：2018-05-17 06:20

本文选题：超声内镜 + 直肠癌　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:研究超声内镜在直肠癌术前TN分期中的诊断价值。方法:收集2014年6月至2016年10月期间于内镜中心行超声内镜TN分期并且进行直肠癌根治术的患者74例,收集所有病例超声图像由经验丰富的内镜医师进行分期,并与术后病理分期进行一致性比较,探讨超声内镜在直肠癌术前TN分期的诊断价值。结果:本研究共纳入74例直肠癌患者,男性42(42/74,56.8%)例,女性32(32/74,43.2%)例,平均年龄55±19岁。超声内镜分期结果为uT1期15例,其中2例过分期为uT2期;uT2期28例,其中过分期为uT3期3例,分期不足为uT1期2例;uT3期21例,其中过分期为uT4期2例,分期不足4例;uT4期10例,其中分期不足1例。EUS对直肠癌T分期准确率为81.1%,T1、T2、T3、T4分期的准确率分别为86.7%、79.3%、78.9%、81.8%。EUS对直肠癌T分期的敏感性及特异性分别为T1 86.7%、96.6%,T2 79.3%、88.9%,T3 78.9%、89.0%,T4 81.8%、98.4%。25例病理结果证实淋巴结转移;超声内镜结果中29例可疑淋巴结转移,与术后病理结果对照显示其中15例为假阳性;超声内镜结果考虑无淋巴结转移45例,术后病理结果提示其中11例为淋巴结阳性。EUS对直肠癌N分期准确性为64.9%,敏感性为56.0%,特异性为69.4%。利用Kappa方法评价EUS分期与病理结果的一致性,T分期K值为0.736(0.4≤K≤0.75,P0.001),N分期K值为0.244(K0.4,P0.001)。结论:1.在判断直肠癌的浸润深度(T分期)方面超声内镜比较准确;2.对于有无淋巴结转移判断较准确,但是敏感性有待提高;3.超声内镜对于直肠癌TN分期准确性,T分期优于N分期。
[Abstract]:Objective: To study the diagnostic value of endoscopic ultrasonography in the preoperative TN staging of rectal cancer. Methods: 74 patients with endoscopic ultrasonography TN staging and radical resection of rectal cancer from June 2014 to October 2016 were collected. The diagnostic value of endoscopic ultrasonography in the preoperative TN staging of rectal cancer. Results: This study included 74 cases of rectal cancer, male 42 (42/74,56.8%), female 32 (32/74,43.2%), with an average age of 55 + 19 years. The results of endoscopic ultrasonography were 15 cases of stage uT1, of which 2 were in uT2 stage and 28 in phase uT2, of which the period was uT3. There were 3 cases, 2 cases of uT1 stage, 21 cases in phase uT3, of which 2 cases were uT4 stage, 4 cases in stage, 10 cases in phase uT4, of which the accuracy rate of.EUS for T staging of rectal cancer was 81.1%, T1, T2, T3, T4 stages were 86.7%, 79.3%, 78.9%, 81.8%.EUS were sensitivity and specificity respectively to T stages of rectal cancer, respectively, 86.7%, 96.6%, specificity and specificity respectively. T2 79.3%, 88.9%, T3 78.9%, 89%, T4 81.8%, and 98.4%.25 cases confirmed lymph node metastasis; 29 cases of suspicious lymph node metastases were found in the results of endoscopic ultrasonography, and 15 cases were false positive compared with postoperative pathological results, and 45 cases without lymph node metastasis were considered by endoscopic ultrasonography, and the postoperative pathological results suggested that 11 cases were lymph node positive.EUS. The accuracy of N staging for rectal cancer was 64.9%, the sensitivity was 56%, and the specificity was 69.4%. using Kappa method to evaluate the consistency of EUS staging with pathological results. The K value of T staging was 0.736 (0.4 < < K < 0.75, P0.001), K value of N staging was 0.244 (K0.4, P0.001). Conclusion: 1. is more accurate in judging the depth of invasion of rectal cancer; 2. for the diagnosis. No lymph node metastasis was accurately diagnosed, but the sensitivity needed to be improved. 3. EUS for rectal cancer TN staging accuracy, T staging is better than N staging.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.37;R445.1

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