经直肠三维超声诊断直肠黏液腺癌与非黏液腺癌的配对病例对照研究

目的 探讨经直肠三维超声对直肠黏液腺癌与非黏液腺癌的鉴别诊断价值.方法 回顾性分析2017年1月至2019年12月中山大学肿瘤防治中心收治的直肠黏液腺癌患者35例.以患者年龄相差不超过2岁、相同性别、相同肿瘤病理T分期及病灶距肛缘距离相差不超过1 cm的基线信息作为匹配条件,按照1:1比例选择条件匹配的直肠非黏液腺癌患...

Value of three-dimensional transrectal ultrasound in diagnosis of rectal mucinous adenocarcinoma and non-mucinous adenocarcinoma: a matched case-control study

ObjectiveTo evaluate the value of three-dimensional (3D) transrectal ultrasound (TRUS) in the diagnosis of rectal mucinous adenocarcinoma and non-mucinous adenocarcinoma. MethodsThis study retrospectively analyzed the clinicopathological data and the characteristics of 3D TRUS images of 35 patients with rectal mucinous adenocarcinoma. Rectal mucinous adenocarcinoma patients were paired with rectal non-mucinous adenocarcinoma patients in the same period at 1:1 (patient's age, ± 2 years old, same gender and pathological T stage of the tumor, and distance form lesion to anal verge of ± 1 cm). The differences in the 3D ultrasonic image features of the two groups were compared. Multivariate logistic regression was used to analyze the predictors of ultrasonic characteristics of mucinous adenocarcinoma, and the diagnostic efficacy of the predictors was calculated by using a four-grid table. ResultsCompared with non-mucinous carcinoma, mucinous carcinoma had longer infiltrating segment [(45.20±20.09) cm vs (37.69±11.38) cm)]. The long-axis layered sign or concentric cross-sectional sign was a typical ultrasound feature in mucinous carcinoma, accounting for 77.1% (27/35), while it was not found in non-mucinous adenocarcinoma. The main pattern of mucinous carcinoma was flat type (51.5%, 18/35) whereas non-mucinous carcinoma was characterized by elevated type (94.3%, 33/35). The above differences were statistically significant (P＜0.05 for all). Conditional logistic regression analysis showed that the long-axis layered sign or cross-sectional concentric sign was a typical feature in the diagnosis of rectal mucinous adenocarcinoma, with an odds ratio (odds ration = 10.720, 95%CI: 2.429-47.300), and its sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 77.1%, 100%, 88.6%, 100%, and 81.4%, respectively. Conclusion3D TRUS can effectively diagnose rectal mucinous adenocarcinoma and non-mucinous adenocarcinoma before treatment.