应用B型超声诊断胃癌淋巴结转移的研究

目的：研究B型超声在观察胃癌淋巴结转移中的价值。方法：对43例例胃癌伴有淋巴结转移的患者进行了病理与术前B型超声对比观察。结果：①B型超声共检出转移性淋巴结18例，检出率为41．9％（18／43），特异性为100％（18／18）；②N1部位转移性率为0．84％，N2部位转移性淋的检出率29．5％，N3部位转移性淋巴结的检出率为61．9％，N3部位淋巴结转移者多伴有N1、N2部位的淋巴结转移；③本组B型超声检测出转移性淋巴结长径范围0．4cm-3.3cm。结论：①与原发肿瘤融合的转移淋巴结、大小趋于正常的转移性淋巴结及胃肠气体干扰为B型超声漏诊为主要原因；②根据部位的不同各站转移性淋巴结的检出率有较大的差异，较易显示距肿瘤较远N2、N3部位的转移性淋巴结，敏感性,特异性高；③B型超声对转移性淋巴结的检出率较低，但结合淋巴结转移由近及远的规律性，仍能与临床选择治疗方案和预后提供依据，具有很大的临床价值。

Value of B Ultrasonic Diagnosis on the Gastric Cancer Patients with Iymphatic Metastasis

Objective:We discussed the value of B Ultrasonic diagnosis on lymphatic metastasis in the patients with gastric cancer.Methods：pathological examination and B ultrasonography of 43 gastric cancer patients with lymphatic metastasis before operation.were comparatively observed. Results:1.Eeighteen cases of gastric cancer with lymphatic metastasis were detected with B ultrasonography and the detectable rate was 41.9%(18/43). The specificity was 100%(18/18).2. The detectable rate of lymphatic metastasis in N1 site was 0.84%, N2 site,29.5% and in N3 site 61.9%. 3.The major diameters of metastatic lymph nodes detected with B ultrasonography in this group ranged from 0.4cm to 3.3cm.Conclusions:1.The main missed diagnoses of B ultrasonography are metastatic lymph nodes fused with primary carcinoma of stamoch and the size of metastatic lymph nodes was similar to that of the normal lymph nodes and interfered by gastrointestinal gas. 2.The detectable rate of metastatic lymph nodes in various sites had great difference.The metastatic lymph nodes in N2,N3 sites farther from the gastric cancer were showed more clear, with low sensitivity and high specificity.3.According to the metastatic role from near by to far region,though the detectable rate of metastatic lymph nodes with B ultrasonography is low, it can also provide the evidences for the selection of clinical therapeutic scheme and the patients' prognosis. So, B ultrasonography has great clinical significance in diagnosing cancer patients with metastatic lymph nodes.