64排螺旋CT联合超声内镜对胃癌术前T分期的诊断价值

目的评价64排螺旋CT（MSCT）联合超声内镜（EUS）在胃癌术前T分期的价值。方法经手术证实的50例胃癌患者,术前均采用64排螺旋CT扫描,同期行EUS检查,综合MSCT及EUS的结果进行术前T分期,并与术后病理对照,评价准确率。结果50例胃癌MSCT术前T分期总体准确率为80％,其中早期胃癌准确率为62．5％,进展期胃癌准确率为83．3％。EUS术前T分期总体准确率为74％,其中早期胃癌准确率为75％,进展期胃癌准确率为73．8％。MSCT联合EUS后对术前胃癌T分期的准确率明显提高,总体准确率为86％,其中早期胃癌准确率为75％,进展期胃癌准确率为88．1％。结论MSCT联合EUS对早期、进展期等各期胃癌的术前T分期准确率明显提高。     

内镜超声检查对胃癌浸润深度淋巴结状况和可切除性术前评估的价值

目的 :探讨内镜超声检查 (EUS)在术前判断胃癌浸润深度、淋巴结状况和可切除性中的临床应用价值。方法 :对经胃镜活检证实的胃癌 12 4例术前行内镜超声检查 ,并与术后病理检查结果对照。结果 :EUS对胃癌 T分期 (浸润深度 )的判断准确率为 82 .4 % ,其中 T1 期为 86 .2 % ,T2 期为 72 .7% ,T3期为 88.9% ,T4 期为 73.9% ,其中 EUS鉴别粘膜和粘膜下癌的准确率为 6 5 .5 %。EUS对胃癌淋巴结状况的判断准确率、淋巴结转移的敏感性和特异性分别为 82 .1%、76 .3%和 89.4 %。EUS判断胃癌可切除性的敏感性和特异性分别为 98.1%和 77.8%。结论 :内镜超声检查对胃癌浸润深度、淋巴结状况和可切除性的术前评估具有较高的临床应用价值。     

Preoperative evaluation of periampullary tumors by endoscopic sonography, transabdominal sonography, and computed tomography.

PURPOSE: The purpose of this retrospective study was to compare the sensitivity of endoscopic sonography (EUS), transabdominal sonography (US), and CT in the detection of, local staging of, and prediction of vascular involvement by or distant metastasis from periampullary tumors. METHODS: Seventy-four consecutive patients with presumed periampullary tumors were evaluated by EUS, US, and CT during a 3.25-year period. The local staging accuracy of the modalities was assessed in the 36 patients with solid tumors who underwent surgery. The sensitivity of the modalities in predicting vascular involvement and distant metastasis was assessed in the 56 patients with carcinomas. RESULTS: EUS was the most sensitive modality in the detection (EUS, 97%; US, 24%; and CT, 39%; p < 0.001 for EUS versus US or CT) and T classification (EUS, 72%; US, 11%; CT, 22%; p < 0.001 for EUS versus US or CT) of periampullary tumors. EUS also had better sensitivity than US in detecting lymph node metastasis from periampullary cancers (EUS, 47%; US, 7%; and CT, 33%; p = 0.02 for EUS versus US; p = 0.7 for EUS versus CT). The accuracy of EUS in determining the T classification (without stent, 81%; with stent, 65%) and N classification (without stent, 80%; with stent, 70%) tended to decrease in the presence of an endobiliary stent, but the differences were not significant. EUS was the most sensitive modality in demonstrating vascular involvement (EUS, 100%; US, 0%; and CT, 33%; p = 0.002 for EUS versus US; p = 0.03 for EUS versus CT) but was not significantly different in detecting distant metastasis (EUS, 11%; US, 44%; and CT, 44%). CONCLUSIONS: EUS is superior to US and CT in the local assessment of periampullary tumors. The staging accuracy of EUS is minimally but not significantly affected by the presence of an endobiliary stent.     

Endoscopic ultrasonography in patients with gastro-esophageal cancer.

For patients with gastro-esophageal cancer ultrasonography (EUS) is superior to any other imaging modality in the assessment of local tumor infiltration and local lymph nodes status. EUS is especially important in the preoperative staging of patients with esophageal cancer and patients with proximal gastric cancer. Here it allows for the identification of those patients with advanced disease who are unlikely to benefit from surgery and in whom a conservative palliative treatment is indicated. In advanced gastric cancer the clinical implications of EUS less clear. Still preoperative EUS is indicated in every patient with cancer of the proximal stomach to assess tumor infiltration in the esophagus. Relatively new is the use of EUS in staging early cancers in order to select patients for local endoscopic treatment. High-frequency miniprobes are the instruments of choice for imaging these lesions. Strict criteria should be applied in the selection of patients for local endoscopic treatment of early gastro-esophageal cancers. EUS guided fine needle aspiration (EUS-FNA) is currently only indicated in patients with esophageal cancer and suspicious celiac lymph nodes. It may become more important if new treatment protocols demand more objective and reliable assessment of lymph node status.     

高频微探头内镜超声在胃癌TN分期中的应用评价

目的评价高频微探头内镜超声检查（EUS）在胃癌TN分期中的价值。 方法胃癌患者98例均行高频微探头内镜超声检查,了解肿瘤侵犯深度、局部淋巴结转移情况,采用外科手术后病理为金标准进行对照,了解EUS在胃癌TN分期中的准确性。 结果（1）EUS对TN分期阳性诊断正确率分别为88.78%,66.33%;（2）EUS对TN分期诊断过深率分别为6.12%,0（P〈0.05）;过浅率分别为5.10%,33.67%（P〈0.05）;（3）EUS对T分期有较高的敏感性（87.10%～100%）和特异性（81.25%～100%）,阳性预测值83.33%～100%,阴性预测值94.37%～100%;EUS对N分期阳性诊断的敏感性、特异性、阳性及阴性预测值分别为52.17%、100%、100%、46.77%。 结论高频微探头内镜超声检查对判断肿瘤侵犯深度的诊断（T分期）较准确,对判断局部淋巴结转移的诊断（N分期）有一定价值。     

超声内镜对胃癌术前分期的临床意义

目的探讨超声内镜对胃癌术前分期的意义。方法对69例胃癌患者进行术前内镜超声检查,并与术后组织病理分期比较。结果在判断胃癌浸润深度T分期上,EUS总的正确率36.2%,其中T1m41.7%,T1sm75%,T2mp100%,T3se66.7%,T4si25%;在判断淋巴结转移N分期上,EUS总的正确率62.3%,其中N-100%,N+53.8%。结论EUS对胃癌术前T及N分期具有重要意义,但是如何避免分期过深或过浅、如何鉴别良恶性淋巴结方面,尚需进一步探讨。     

Gastric cancer: diagnosis and treatment options

Although the overall incidence of gastric cancer has steadily declined in the United States, it is estimated that more than 12,000 persons died from gastric cancer in 2003. The incidence of distal stomach tumors has greatly declined, but reported cases of proximal gastric carcinomas, including tumors at the gastroesophageal junction, have increased. Early diagnosis of gastric cancer is difficult because most patients are asymptomatic in the early stage. Weight loss and abdominal pain often are late signs of tumor progression. Chronic atrophic gastritis, Helicobacter pylori infection, smoking, heavy alcohol use, and several dietary factors have been linked to increased risks for gastric cancer. Esophagogastroduodenoscopy is the preferred diagnostic modality for evaluation of patients in whom stomach cancer is suspected. Accurate staging of gastric wall invasion and lymph node involvement is important for determining prognosis and appropriate treatment. Endoscopic ultrasonography, in combination with computed tomographic scanning and operative lymph node dissection, may be involved in staging the tumor. Treatment with surgery alone offers a high rate of failure. Chemotherapy and radiotherapy have not improved survival rates when used as single modalities, but combined therapy has shown some promise. Primary prevention, by control of modifiable risk factors and increased surveillance of persons at increased risk, is important in decreasing morbidity and mortality.     

胃癌患者血清CA724，NSE和 PGR水平联合检测对肿瘤临床病理分期及淋巴结转移的诊断价值

目的　探讨血清糖类抗原 724（CA724）、神经元特异性烯醇化酶（ NSE）和胃蛋白酶原比值（ PGR）在胃癌诊断、临床分期及淋巴结转移中的临床应用价值。方法　采用电化学发光法及酶联免疫吸附法（ ELISA）测定 2017年 4月 ~2019年 4月入住于陕西省人民医院的 84例胃癌患者（胃癌组）及 80例胃良性病变患者（良性病变组）血清中 CA724,NSE和 PGR水平,观察上述指标在各组患者中的表达水平,评价其在胃癌临床分期和淋巴结转移中的应用价值,并分析这三项指标联合检测的诊断效能。结果　胃癌组血清 CA724和 NSE水平与良性病变组对比,明显较高, PGR水平与良性病变组对比,明显较低,差异均有统计学意义（ t=63.327,48.026,7.146,均 P＜ 0.05）;胃癌组中, III~IV期患者血清 CA724和 NSE水平与 I~II期患者对比,明显较高, PGR水平与 I~II期患者对比,明显较低,差异均有统计学意义（ t=46.687,47.916,16.358,均 P＜ 0.05）;胃癌组中,淋巴结转移者血清 CA724和 NSE水平与未转移者对比,明显较高, PGR水平与未转移者对比,明显较低,差异均有统计学意义（ t=49.679,30.872,22.573,均 P＜ 0.05）; CA724, NSE和 PGR三项联合检测准确度、特异度、灵敏度分别为 92.68%, 88.75%和 96.43%,与单项检测对比,均明显较高,差异均有统计学意义（χ2=5.096~20.993,均 P＜ 0.05）。结论　CA724, NSE 和 PGR在胃癌患者中表达异常,且与胃癌临床分期及淋巴结转移有一定关联,三者联合检测,有助于胃癌的鉴别诊断。     

非小细胞肺癌淋巴结的无创分期评价

目的 本研究通过对经胸部CT解剖显像后的非小细胞肺癌(NSCLC)患者进行18F-FDG PET全身扫描及经食管超声解剖显像，着重评估无创检查对NSCLC术前分期准确性及价值。方法 56例经病理证实的NSCLC术前患者经CT扫描、全身^18F-FDG PET显像，并与手术病理结果进行回顾性的分析。结果 所有56例NSCLC患者肺部及相应转移部位^18F-FDG摄取增高，^18F-FDG PET对预测NSCLC纵隔淋巴结转移的灵敏度为83％，特异性为91％，CT扫描纵隔淋巴结转移的灵敏度为58％，特异性为78％，其中38例行经食管超声解剖显像纵隔淋巴结转移的灵敏度为77％，特异性为72％。^18F-FDG PET对NSCLC对纵隔淋巴结优于胸部CT解剖显像和经食管超声解剖显像。结论 ^18F-FDG PET在对NSCLC的术前分期均优于CT等常规检查，但PET在精确定位方面仍然需要结合解剖显像，图像融合技术等是发展的方向。     

胃癌内镜超声分期与MMP-9基因表达的关系

目的 探讨内镜超声（EUS）对胃癌的术前分期及其与肿瘤转移相关基因表达的关系.方法 63例胃癌患者术前行胃镜和EUS检查并进行术前分期,同时运用ELISA法检测术前MMP-9血清水平,应用免疫组织化学技术和原位杂交技术检测胃癌组织中MMP-9蛋白的表达并与术后病理分期比较.结果 EUS对胃癌侵犯深度判断的总准确率为 80.95%,对淋巴结转移的总准确率为 73.02%.胃癌患者血清MMP-9水平与组织中MMP-9蛋白及MMP-9 mRNA表达呈一致性.MMP-9表达水平与胃癌组织浸润程度、EUS分期、淋巴结转移关系密切（P〈0.05）.联合EUS和MMP-9对胃癌侵犯深度判断的准确率明显提高,其总准确率为 95.22%.结论 ①EUS对胃癌的分期具有其分子生物学改变的基础.②胃癌患者术前血清MMP-9水平对EUS术前分期有参考价值,若显著增高者,术前EUS检查时,应注意癌肿是否已达或超过浆膜层.③EUS联合术前检测MMP-9血清水平,有利于提高对胃癌浸润转移判断的准确性.     

内镜超声结合E-钙粘素和CD44v6检查在食管癌诊断中的价值

目的　探讨术前内镜超声检查 (EUS)及E -钙粘素 (E -CD)、CD4 4v6表达在食管癌术前分期诊断中的价值。方法　对 5 8例食管鳞癌患者术后标本应用SP法检测E -CD和CD4 4v6的表达 ,对其中 30例食管鳞癌患者术前进行了EUS。结果　EUS诊断食管鳞癌术前TNM分期与术后病理分期对照 ,其T期总的准确率为 83% ,N期总的准确率为 77%。E -CD、CD4 4v6阳性表达率与食管鳞癌患者肿瘤细胞浸润深度、淋巴结转移显著有关 (P <0 .0 1) ,与食管癌患者临床分期有关 (P <13.0 5 )。但在食管鳞癌原发灶中E -CD和CD4 4v6表达无相关性 (P >0 .0 5 )。食管癌患者中UESTN分期与E -CD、CD4 4v6阳性表达率显著相关 (P<0 .0 1)。结论　E -CD和CD4 4v6均可反映食管癌生物学行为的指标 ,将两种细胞粘附分子的检测与EUS结合起来 ,能更准确地对食管癌患者进行TNM分期。     

进展期胃癌淋巴结转移的螺旋CT征象与病理学检查相对照

目的 探讨胃癌淋巴结转移的螺旋CT征象及其与病理学的关系.方法 对59例进展期胃癌患者行螺旋CT平扫及三期动态增强扫描. 结果①胃癌淋巴结螺旋CT呈融合型、强化明显、不均匀强化及直径≥9 mm者,病理转移的阳性率较高(P<0.05);②胃癌组织呈低分化、Borrmann Ⅲ+Ⅳ、浸润深度T3～4、TNM分期Ⅲ+Ⅳ者,螺旋CT诊断淋巴结转移的阳性率较高(P<0.05),而与肿块的大小无关. 结论 胃癌淋巴结的螺旋CT征象(淋巴结分布类型、大小、强化程度、强化方式)可反映转移淋巴结的病理特性;胃癌组织的病理学特性(癌组织的分化程度、Borrmann分型、浸润深度及TNM分期)决定螺旋CT判定淋巴结转移的阳性率.综合胃癌组织及淋巴结的各种螺旋CT征象有助于提高CT诊断淋巴结转移的准确性.     

超声内镜对食管癌的诊断价值

应用超声内镜（EUS）对23例食管癌患者进行T分期诊断。结果表明：EUS诊断癌的浸润深度与病理诊断的总符合率为83．75％；EUS诊断淋巴结转移与病理诊断的符合率为80％。EUS对食管癌手术治疗的方式有重要意义，将成为术前重要的检查手段。     

Endosonography versus helical computed tomography for locoregional staging of gastric cancer

BACKGROUND AND STUDY AIMS: Endosonography (EUS) has been shown to be more accurate than incremental computed tomography (CT) in the local (T) and regional (N) staging of gastric carcinoma; however, EUS has never been compared with helical CT (HCT). The fifth edition of the TNM classification changed the guidelines for N-staging of gastric carcinoma. The accuracy of imaging methods in this new system remains unknown. PATIENTS AND METHODS: Staging accuracy of EUS and HCT were compared prospectively with pathological or intraoperative findings in 88 gastric carcinoma patients. Staging was done according to the fourth and fifth editions of the TNM classification. EUS was done with a radial echo endoscope, and HCT with a scanner with two rows of detectors (two-phase contrast-enhanced scanning of a water-filled stomach). RESULTS: The T-staging accuracy of EUS (63 %, CI 52 - 73 %) was superior to the accuracy of HCT (44 %, CI 34 - 55 %; P = 0.021). N-staging accuracy of both methods was similar when the fourth edition of the TNM classification was used (EUS 47 %, CI 34 - 60 %; HCT 52 %, CI 38 - 65 %). However, HCT was more accurate than EUS when the fifth edition of the classification was applied (EUS 30 %, CI 18 - 43 %, HCT 47 %, CI 34 - 60 %; P = 0.044). The accuracy of detection of lymph node metastases was similar for both methods (EUS 67 %, CI 54 - 78 %; HCT 77 %, CI 64 - 86 %). CONCLUSIONS: EUS is more accurate than HCT in the T-staging of gastric carcinoma. Both methods are comparable for N-staging, when this is done according to the older, fourth edition of the TNM classification. If the fifth edition is used, EUS is less accurate than HCT.     

Impact of endoscopic ultrasound combined with fine-needle aspiration biopsy in the management of esophageal cancer

BACKGROUND AND STUDY AIMS: Endoscopic ultrasound (EUS) in combination with fine-needle aspiration biopsy (FNA) is a highly accurate method for the preoperative staging of esophageal cancer. Its impact on medical decision-making and the cost of care is unknown. This prospective case series was undertaken in order to determine the impact of EUS in combination with FNA on patients' choice of therapy and on the cost of care. PATIENTS AND METHODS: Sixty consecutive patients with esophageal cancer, referred for preoperative EUS staging in a large tertiary-care academic medical center, were enrolled. The accuracy of EUS, the impact of EUS-based staging on the patients' choice of therapy, and costs were studied. RESULTS: The accuracy rates for EUS combined with FNA in tumor and lymph-node staging were 83 % and 89 %, respectively. Twenty-five patients (42 %) had EUS stage I and II and were candidates for curative surgery. Twenty-eight patients (47 %) had stage III, and seven (12 %) had stage IV. All patients with stage I had surgery, while all patients with stage IV had medical therapy. The majority (62 %) of patients with stage II had surgery, while only a minority (25 %) of patients with stage III had surgery. Thirty-six patients (60 %) underwent medical therapy. Patients' medical decisions in favor of surgical or medical therapy correlated strongly with the results of their EUS staging ( P = 0.005), but not with age, sex, or referring physicians (surgeons vs. nonsurgeons). EUS-guided therapy potentially decreased the cost of care by $ 740 424 ($ 12 340/patient) by reducing the number of thoracotomies. CONCLUSIONS: Patients' decisions regarding therapy correlated with their overall tumor staging, suggesting that the information provided by EUS played a significant role in patients' decision-making. The use of EUS in combination with FNA reduces the cost of managing patients with esophageal cancer.     

PET-CT和SPECT-CT联合在评估颈部淋巴结转移阴性喉鳞癌患者前哨淋巴结微转移中的临床价值

目的评价PET-CT与SPECT-CT联合探测在颈部淋巴结转移阴性(cN0期)喉鳞癌患者颈部前哨淋巴结(SLN)转移中的临床应用价值。方法选取15例cN0期喉鳞癌患者,术前行18F-FDG PET-CT显像疑似淋巴结,同时行99锝m-硫胶体(99Tcm-SC)SPECT-CT显影SLN,二者结合对微转移SLN进行定位及定性,术中利用手持式γ探测仪探测确定SLN,将手术切除的SLN及非SLN行术中快速病理检查判断转移。结果 15例喉鳞癌患者术前经PET-CT显像疑似淋巴结及SPECT-CT显影SLN,2例均未显影。其中有13例PET-CT显像13枚疑似淋巴结,SPECT-CT显影23枚SLN,13枚疑似淋巴结均经CT定位与相应SLN重合。术中γ探测仪探出SLN 22枚,符合率为92.3%。手术切除SLN共计23枚,非SLN共计44枚,6例患者(40%)经病理检查证实淋巴结转移,其中SLN的转移度为21.7%(5/23),高于非SLN转移度2.3%(1/44)(P=0.008)。6例患者转移患者显像淋巴结标准化摄取比值(SUV值)均值为3.51±1.76,高于9例无转移患者显像淋巴结的SUV均值1.58±0.64(P=0.010)。SLN检出率为86.7%。SLN检测的灵敏度为83.3%、准确率为86.7%、假阴性率为16.7%。结论术前联合PET-CT与SPECT-CT并参考SUV值对cN0期喉鳞癌患者微转移SLN定性及定位,有助于手术方案选择的合理性,术中结合γ仪探测SLN可提高颈清范围的准确性。     

多排螺旋CT特殊扫描对胃癌术前分期的临床研究

目的:评价多排螺旋CT特殊扫描(两次给药三次扫描)对胃癌术前T分期诊断的准确性及诊断胃癌淋巴结转移的可行性。材料和方法:对30例临床确诊为胃癌的住院患者进行术前16排螺旋CT特殊扫描(即两次给药三次扫描),并根据SCT结果作出分期诊断。所有病人手术后,取病理并进一步进行病理TNM(p-TNM)分期。结果:MSCT三相扫描对胃癌术前分期的总准确度为73.3%,对进展期胃癌术前分期的准确度为78.5%,以病理结果作为金标准,MSCT对胃癌淋巴结转移诊断的准确率为73.3%,敏感度为75.0%,特异度为70.0%,阳性预测值为83.3%,阴性预测值为58.3%。结论:SCT三相扫描对胃癌术前T分期及淋巴结转移诊断有重要的临床价值。     

超声内镜与CT对消化道恶性肿瘤术前分期的价值比较

目的 探讨超声内镜与ＣＴ在消化道恶性肿瘤术前分期中的价值。方法 ４３例临床确诊为消化道恶性肿瘤的患者,术前分别行超声内镜和ＣＴ分期,并与术后病理结果对照。结果 浸润层次（Ｔ分期）方面,超声内镜准确性为８８．４％（３８／４３）,ＣＴ为５５．８％（２４／４３）。过低分期超声内镜、ＣＴ分别为４．６％和３０．２％,过高分期分别为７．０％和１４．０％。超声内镜、ＣＴ术前Ｔ分期与术后病理分期准确率比较,经ｘ＾     

高频微探头超声内镜检查在结直肠癌术前TN分期中的价值

目的:探讨高频微探头超声内镜(EUS)检查在结直肠癌TN分期中的价值.方法:145例结直肠癌患者术前采用高频微探头EUS检查进行TN分期,并与术中探查和术后病理检查结果进行比较.结果:结直肠癌患者术前高频微探头EUS检查的T、N分期与术后病理分期符合率分别为84.83％和70.34％,其中T1、T2、T3、T4期的符合率分别为88.89％、85.71％、84.27％和80.00％.对有无淋巴结转移的诊断符合率较高,分别为98.41％(N+)、92.68％ (N0).N1、N2分期的符合率分别为76.92％和16.22％.结论:高频微探头EUS检查能较准确地判断结直肠癌的浸润深度(T分期),尤其适用于早期结直肠癌和癌性狭窄患者的术前分期;对有无淋巴结转移判断较准确,对N分期,尤其N2分期准确性有待提高.     

血清MMP-7、MMP-9联合胃充盈超声在胃癌术前TNM分期的诊断价值

目的：通过检测血清MMP-7、MMP-9表达与胃癌患者分化程度、肿瘤浸润深度、淋巴结转移情况相关性后,再探讨胃充盈超声、血清MMP-7、MMP-9及联合筛查在不同分期胃癌中价值性目的表述不清楚,探索的是新方法或新技术的价值,不是探索结果。方法：回顾性分析的82例胃癌患者在2018年2月至2020年2月期间收治,均进行血清MMP-7、MMP-9以及胃充盈超声(FUS；Filling Ultrasound)检测,分析血清在胃癌患者分化程度、肿瘤浸润深度、淋巴结转移中表达情况后,以病理活检、《国际抗癌联盟及美国肿瘤联合会胃癌TNM分期系统(第8版)》为金标准,用ROC分析胃充盈超声、血清MMP-7、MMP-9及联合筛查在不同分期胃癌中价值性,指标用于胃癌术前分期的价值。缺乏分期的标准,如根据AJCC第八版？结果：MMP-7、MMP-9表达阳性率与分化程度、淋巴结转移情况、浸润深度存在一定相关性(P＜0.05)。而FUS对T1期~T4期总准确率84.51%,对N1期~N3期总准确率85.92%,对M1分期准确率84.51%；MMP-7对T1期~T4期总准确率81.69%,对N1期~N3期总准确率78.87%,对M1分期准确率83.10%；MMP-9对T1期~T4期总准确率80.28%,对N1期~N3期总准确率77.46%,对M1分期准确率81.69%。同时经血清检测,T4期患者MMP-7、MMP-9高于其他分期者；N3期患者MMP-7、MMP-9高于其他分期者；M1期患者MMP-7、MMP-9高于M0期者(P＜0.05)既然是对比,请列出单方面诊断结果,以及什么单方面诊断结果,是影像还是血清指标？。ROC曲线分析显示,FUS诊断对T分期的AUC为0.741；对N分期的AUC为0.748；对M分期的AUC为0.695；MMP-7诊断对T分期的AUC为0.681；对N分期的AUC为0.667；对M分期的AUC为0.643；MMP-9诊断对T分期的AUC为0.720；对N分期的AUC为0.674；对M分期的AUC为0.636；联合诊断对T分期的AUC为0.993；对N分期的AUC为0.993；对M分期的AUC为0.948,提示联合诊断具有一定准确率。结论：血清MMP-7、MMP-9表达与胃癌分期、分化程度、肿瘤浸润深度密切相关,联合FUS诊断,可提高对胃癌分期判断准确性。