摘要
目的:阐述EUS对术前胃癌浸润深度(T分期)诊断的准确性,评价其对胃癌手术或内镜下黏膜可切除性的指导意义.方法:回顾性分析78例胃癌手术患者临床资料.患者术前均行超声内镜检查,TNM分期分析比较术前T分期与术后手术及病理结果.结果:与术后病理结果对比,EUS术前T分期总准确率为69.2%,T1、T2、T3、T4分期的准确率分别为83.3%、61.9%、40.0%和100%,对手术可切除性预测的敏感性为80.8%(63/78)其中EUS准确诊断早期胃癌5例,但1例胃黏膜下层癌,被诊断为固有肌层癌.T4期胃癌手术切除率仅为42.3%(11/26).结论:EUS对判断胃癌浸润深度准确率较高,能较准确诊断早期胃癌,对指导内镜下黏膜切除术有很大帮助.而对T4期胃癌患者,虽然诊断准确性很高,但对指导根治性手术的意义不大.
AIM： To determine the diagnostic accuracy of endoscopic ultrasonography （EUS） for preoperative invasion depth of gastric cancer （T staging） and to evaluate the instructive significance of EUS in gastric cancer surgery and resectability of endoscopic mucosa. METHODS： A total of 78 patients with pathologically confirmed gastric cancer were examined by EUS before operation. Furthermore, they underwent TNM staging, and the preoperative examination results were compared with post- operative pathological results. RESULTS： Among the 78 patients, compared with post-operative pathological results, the overall accuracy of stage T of EUS was 69.2%, and the accuracy rates of T1, T2, T3 and T4 were83.3%, 61.9%, 40.0% and 100%, respectively. Meanwhile, the sensibility to the prediction of operational respectability was up to 80.8%. Five cases with early gastric cancer （EGC） diagnosed by EUS had been confirmed by the operation. However, 1 case wiht gastric submucosa cancer was diagnosed as muscularis propria （MP） cancer by EUS. Resectability of gastric cancer at stage T4 was only 42.3% （11/26）. CONCLUSION： EUS bears a high accuracy rate to determine the invasion depth of gastric cancer. EUS does much favor to endoscopic mucosal resection （EMR） because EGC could be relatively accurately judged by EUS. While gastric cancer patients at stage T4 need to search new examination to confirm NM staging of gastric cancer, avoid surgery and choose a suitable therapeutic method.
出处
《世界华人消化杂志》
CAS
北大核心
2009年第16期1665-1668,共4页
World Chinese Journal of Digestology
关键词
胃癌
超声内镜
手术
内镜下黏膜切除治疗
Gastric cancer
Endoscopic ultrasonography
Operation
Endoscopic mucosal resection
