摘要
目的研究直肠腔内超声（TRUS）联合癌胚抗原（CEA）检查对直肠癌术前TNM分期和术后病理pTNM分期诊断的一致性。方法将病理证实的118例直肠癌患者按随机数字表法分为术前行单独TRUS检查组和TRUS联合血清CEA检查组各59例，回顾性分析两组术前分期与术后病理分期结果的一致性。结果TRUS联合CEA组的术前T分期与术后病理诊断一致47例，准确度为79．7％，术前N分期与术后病理诊断一致42例，准确度为77．8％。而TRUS组术前T分期与术后病理诊断一致51例，准确度为86．4％，术前N分期与术后病理诊断一致30例，准确度为57．7％。与术后病理T、N分期一致性检验显示，直肠癌术前TRUS联合CEA组T、N分期与术后病理T、N分期有较好一致性（κ=0．685，0．544，均P=0．000），而TRUS组中T分期一致性较好（κ=0．755，P=0．000），N分期一致性较差（κ=0．154，P=0．229）。结论TRUS联合CEA检查术前评估直肠癌可提高术前分期的准确性，为手术决策提供依据，提高手术方案预测的符合率，为直肠癌术前精准诊断和个体化治疗提供依据。
Objective To study the consistency of preoperative staging by transrectal uhrasonography （TRUS） combined with serum carcinoembryonic antigen （CEA） and the postoperative pathological TNM staging （PTNM）. Methods 118 rectal cancer patients pathologically proven were divided into preoperative TRUS combined with CEA group （59 cases） and along TRUS group （59 cases）. The consistency of preoperative stag in 2 groups and postoperative pathological stage was analyzed retrospectively. Results In TRUS combined with CEA group, the accuracy of T stage was 79.7 % （47/59）, and the accuracy of N stage was 77.8 % （42/59）, compared with the postoperative pTNM. While in along TRUS group, the accuracy of T stage was 86.4 % （51/59）, and the accuracy of N stage was 57.7 % （30/59）. The consistencies of T and N stage in TRUS combined with CEA group and postoperative pTNM were better （κ = 0.685, P = 0.000; κ = 0.544, P = 0.000）. While the consistency of T stage in along TRUS and postoperative pTNM was better （κ = 0.755, P = 0.000）, but that of N stage was poor （κ = 0.154, P = 0.229）. Conclusion Preoperative evaluation by the TRUS combined with CEA can increase the accuracy of preoperative stage which can provide more reliable basis for decision-making and improve the rate of coincidence of operative procedures in line with forecasts. At the same time, it can provide the basis for the accurate preoperative diagnosis and individualized treatment.
出处
《肿瘤研究与临床》
CAS
2011年第11期765-767,共3页
Cancer Research and Clinic
关键词
直肠肿瘤
腔内超声检查
癌胚抗原
肿瘤分期
Rectal neoplasms
Endosonography
Carcinoembrynonic antigen
Neoplasms staging
