超声内镜在胃癌术前诊断中的应用分析

目的探讨超声内镜(EUS)在胃癌术前TN分期中的应用经验。方法术后病理检查证实为胃癌而且使用超声内镜进行了术前TN分期的患者352例,对其资料进行回顾性分析。结果 EUS胃癌术前T分期总正确率为81.25%,其中T1为85.58%,T2为73.91%,T3为82.14%,T4为83.33%,与术后病理结果比较具有高度一致性(Kappa系数为0.75)。EUS对胃癌术前N分期总的正确率为52.84%,其中N0为85.56%,N1为56.69%,N2为28.09%,N3为26.09%,与术后病理结果比较具有一般一致性(Kappa系数为0.33)。将病变部位分为贲门、胃底、胃体、胃窦、幽门,不同部位之间的检测正确率比较,差异无统计学意义(P0.05)。结论EUS在胃癌术前诊断中具有临床意义,其中T分期可为合理制定治疗方案提供依据,N分期准确性有待提高。

The application experiences of endoscopic ultrasonography in preoperative diagnosis for gastric cancer

Objective To discuss the application experiences of endoscopic ultrasonography (EUS)in preoperative TN staging for gastric cancer. Methods The retrospective analysis was performed that 352 gastric cancer patients who were confirmed by postoperative pathological diagnosis and underwent preoperative assessment of T and N stage by EUS. Results The overall accuracy rate of EUS for T stage was 81. 25% . For T1,T2,T3 and T4 stage was 85. 58% ,73. 91% ,82. 14% and 83. 33% ,respectively. Comparing with the consistency of preoperative T stage and postoperative pathological results,the Kappa value was 0. 75,the consistency was high. The overall accuracy rate for N stage by EUS in identifying lymph node metastasis was 52. 84% . For N0,N1,N2 and N3 stage was 85. 56% ,56. 69% ,28. 09% and 26. 09% ,respectively. Comparing with the consistency of preoperative N stage and postoperative pathologi-cal results,the Kappa value was 0. 33,the consistency was general. Compared to the different lesion sites, including gastric cardia,gastric fundus,gastric body,gastric antrum and gastric pylorus,the rates had no significant differences(P > 0. 05). Conclusions EUS is effective in diagnosing for preoperative stage of gastric cancer,and T stage by EUS can provide the basis in formulating the reasonable treatment. Howev-er,the accuracy in determining N stage should be improved.