超声小探头对结直肠癌术前分期诊断的初步研究 |
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引用本文: | 鲁志诚,孙爱武,张奕荫,赵振刚,黄宣,封月圆,陈伟平,吕桂泉. 超声小探头对结直肠癌术前分期诊断的初步研究[J]. 中华消化内镜杂志, 2001, 18(5): 267-270 |
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作者姓名: | 鲁志诚 孙爱武 张奕荫 赵振刚 黄宣 封月圆 陈伟平 吕桂泉 |
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作者单位: | 1. 浙江省肿瘤医院超声内镜室 2. 浙江省肿瘤医院腹部外科 |
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摘 要: | 目的:超声小探头(ultrasonic miniprobe,UMP)应用于结、直肠癌术前分期的准确性及可行性。方法:对50例结、直肠癌患者做UMP检查,对准病灶进行全瘤扫描,择最佳影像冻结、摄片,退出UMP,最后做活组织检查,全部病例均行根治术,癌周淋巴结分组编号、装瓶、送病理检查。结果:本组UMP对50例结、直肠浸润深度(T分期)与术后病理浸润深度对比,其准确率T1-T4期分别为75%,80%,88%及67%,T分期的总准确率为84%(P<0.01),过高分期5例(10%),过低分期3例(6%);N分期,UMP诊断阳性淋巴结(n=22),术后病理(n=28),准确率795,UMP诊断阴性淋巴结(n=20),术后病理(n=22),准确率91%,总准确率84%(42/50),敏感性79%,特异性为91%(P<0.01)。结论:(1)UMP是当前应用于结、直肠癌术前TNM分期最有实用价值的方法之一。肿瘤狭窄患者适应术前分期检查。(2)UMP系高频超声频探头,由于超声穿透深度的限制。对远处转移的M分期是不可能的。(3)UMP对浸润深度及处淋巴结转移有一定的参考价值。并应结合其它影像检查如腹部B超、CT等,扬长弃短,相辅相成,以提高术前分期的准确性及完整性。
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关 键 词: | 超声小探头 结直肠肿瘤 肿瘤转移 |
修稿时间: | 2001-05-17 |
Pre liminary study on preoperative TNM staging with ultrasonic mini- probe in diagnosis of colorectal cancer |
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Abstract: | Objective To study on the feasibility and accuracy of ultrasonic mini-probe (UMP) for preoperative TNM staging in diagnosis of colorectal cancer. Methods In fifty patients with colorectal cancer preoperative TNM category examinations were performed by UMP(12 MHz/20 MHz), and compared UMP findings with pathological outcomes after surgical resection. Results The accuracy of UMP in diagnosis of infiltrative depth (T staging) of colorectal cancer was 75%(uT1), 80%(uT2), 88%(uT3), and 67%(uT4), respectively, and the total accuracy was 84% in all cases (P< 0.01). The total accuracy of UMP in diagnosis of lymph node metastasis (N staging) was 84% in all cases (P< 0.01), the sensitivity and specificity was 79% and 91%, respectively . The positive and negative predictive value was 92% and 77%, respectively. Conclusions (1) UMP is, at present, one of the most valuable practicable procedures in preoperative TNM staging of colorectal cancer, especially, in some patients with in filtrative malignant stenosis;(2) UMP is impossible for M staging with distant metastasis due to the limitation of penetrating depth of high frequency ultrasound; (3) UMP in diagnosis of preoperative TNM staging of colorectal cancer should be combined with other imaging techniques ,for example, abdominal B scan, CT and so forth, so as to improve the accuracy and integrity of preoperative staging in colorectal cancer. |
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Keywords: | Ultrasonic mini-probe Colorectal neoplasms Neoplasm metastasis |
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