双重超声造影在胃癌术前分期中的价值

目的 评价双重超声造影在胃癌手术前分期中的应用价值.方法 62例经胃镜活检证实的胃癌患者术前行双重超声造影检查进行术前分期,并与术后病理检查结果 对照.结果 胃窗超声造影术前T分期的准确率为72.9%,其中T1、,12、13和T4期的准确率分别为66.7%、60.0%、76.9%和71.4%;诊断区域淋巴结转移的敏感度为74.5%(35/47),特异度为66.7%(8/12),准确率为72.9%(43/59),Youden指数为0.41.双重超声造影T分期的准确率为88.1%,其中T1、T2、T3和T4期的准确率分别为66.7%、80.0%、89.7%和100%;诊断区域淋巴结转移的敏感度为89.4%,特异度为75.0%,准确率为86.4%,Youden指数为0.76.胃窗超声造影和双重超声造影术前T分期的准确率差异有统计学意义(P=0.036),但两者诊断区域淋巴结转移的准确率差异无统计学意义(P＞0.05).结论 双重超声造影对胃癌术前分期具有较高的临床应用价值.

Diagnostic value of double contrast-enhanced ultrasonography in preoperative staging of gastric cancer

Objective To evaluate the clinical value of double contrast-enhanced uhrasonography using oral and intravenous contrast agents in preoperative staging of gastric cancer.Methods Sixty-two patients with biopsy-proven gastric cancer were enrolled into this study,and were examined by double contrast-enhanced gastric uhrasonography preoperatively.The results were compared with postoperative pathologic findings.Results The accuracy of oral contrast-enhanced gastric uhrasonography and double contrast-enhanced ultrasonography in determining the T stage of gastric cancer was 72.9%(T1:66.7%,T2:60.0%,T3:76.9%,T4:71.4%)and 88.1%(T1:66.7%,T2:80.0%,T3:89.7%,T4:100%),respectively,with a statistically significant difference between the two methods(P =0.036).The sensitivity,specificity,accuracy and Youden index of oral contrast-enhanced gastric ultrasonography and double contrast-enhanced uhrasonography in assessment of lymph node metastasis were 74.5%,66.7%,72.9%,and 0.41 versus 89.4%,75.0%,86.4%,0.76,respectively.No significant difference in the accuracy of assessment for lymph node metastasis was observed(P ＞ 0.06).Conclusion Double contrastenhanced ultrasonography is useful for preoperative staging of gastric cancer,especially for T staging.