超声内镜在进展期直肠癌术前精确分期中的价值

摘要

Objective:To research the clinical value of endoscopic ultrasound in the staging of rectal cancer.Methods:All 71 cases of rectal cancer patients in our hospital from June 2013 to December 2016 were selected as the research objects, who accepted EUS evaluation before operation.The accuracy of T and N staging of EUS was evaluated by comparing with the pathological results.Results:There was significant coincidence in T staging(Kappa =0.751 ±0.067,P ＜0.05),and the accuracy was 83.1％ totally,93.0％,83.1％,90.1％,100％ for T1,T2,T3,T4 respectively.There was good coincidence in N staging(Kappa =0.536 ±0.092,P ＜0.05),and the accuracy was 76.1％ totally,81.7％,76.1％,94.4％ for N0, N1, N2 respectively.Conclusion:EUS has considerable accuracy both in preoperative T staging and N staging of rectal cancer,which can provide important reference for clinicians to make individualized treatment plan.%目的:分析进展期直肠癌患者在术前接受超声内镜(endoscopic ultrasound,EUS)检查,进行肿瘤T分期与N分期的准确性.方法:回顾性分析2013年6月至2016年12月间共71例采用EUS检查进行术前分期的直肠癌患者临床资料,将EUS术前分期结果与术后病理分期进行比较.结果:EUS评估直肠癌术前T分期的总体准确率为83.1％,评估T1、T2、T3及T4期病变的准确率分别为93.0％、83.1％、90.1％和100％,与术后病理T分期一致性非常好(Kappa=0.751±0.067,P＜0.05).EUS评估直肠癌术前N分期的总体准确率为76.1％,对N0、N1及N2分期的准确率分别为81.7％、76.1％和94.4％,与术后病理N分期一致性较好(Kappa =0.536 ±0.092,P＜0.05).结论:EUS进行直肠癌术前T分期与N分期判断均有较高的准确性,可以为临床医生制定个体化治疗方案提供重要参考.