【摘要】：目的：探討微探頭超聲內(nèi)鏡(MUP)在直腸癌術(shù)前TNM分期中的價(jià)值。 方法：對71例手術(shù)切除的直腸癌患者術(shù)前行12MHz MUP檢查,收集所有超聲圖像后由同一名內(nèi)鏡超聲醫(yī)師根據(jù)UICC最新第7版直腸癌TNM分期指南進(jìn)行TN分期,并與術(shù)后病理結(jié)果進(jìn)行回顧性比較。 結(jié)果：12MHz MUP對71例直腸癌T分期的總符合率為72%(51/71),其中各期診斷準(zhǔn)確率為T182%, T276%, T390%, T495%。MUP對直腸癌T分期的敏感度和特異度分別為T1(早期直腸癌)46%、100%,T292%、68%,T378%、93%,T478%、98%。T分期過高及不足分別為21%(15/71)及7%(5/71)。MUP對直腸癌N分期符合率為73%(52/71),N分期的準(zhǔn)確度,敏感度和特異度分別為NO73%、93%、12%,N183%、20%、93%,N290%、0、100%。N分期過度及分期不足分別為6%(4/71)和21%(15/71)。MUP對直腸上段(距肛門12cm)、中段(7-12cm)及下段(0-6cm)直腸癌T分期診斷符合率分別為100%、74%、68%,三組間兩兩符合率無統(tǒng)計(jì)學(xué)差異(P0.05),直腸下段及直腸中上段的符合率差異也無統(tǒng)計(jì)學(xué)意義(P0.05)。腫瘤直徑大于2cm組相比小于2cm組診斷符合率較低(57%vs73%),但差異無統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論：MUP對直腸癌術(shù)前TN分期有較高價(jià)值,尤其是對早期直腸癌(T1)的特異度很高,但對N+的診斷敏感度有待進(jìn)一步提高。提高臨床醫(yī)師水平、在病灶體積較大及淋巴結(jié)探查時(shí)選擇穿透性更強(qiáng)頻率較低的標(biāo)準(zhǔn)鏡,必要時(shí)結(jié)合EUS-FNA等技術(shù)可以提高EUS對直腸癌術(shù)前分期的水平。
[Abstract]:Objective: to evaluate the value of microprobe endoscopic (MUP) in preoperative TNM staging of rectal cancer. Methods: 12MHz MUP was performed in 71 patients with rectal cancer before operation. After all ultrasound images were collected, TN staging was performed by the same endoscopic ultrasound physician according to the latest TNM staging guidelines for rectal cancer in the seventh edition of UICC. A retrospective comparison was made between the pathological results and postoperative pathological results. Results the overall coincidence rate of MUP was 72% (51 / 71) for 71 cases of rectal cancer T staging, in which the accuracy rate was T1822, T276, T390. the sensitivity and specificity of T495%.MUP for T staging of rectal cancer were T 1 (early rectal cancer) 46268T 378N 933T 478M 93T 478U 98.T was too high and insufficient, respectively. The accuracy of 21% (15 / 71) and 7% (5 / 71). MUP for N staging of rectal cancer was 73% (52 / 71). The sensitivity and specificity of NO73%,93%,12%,N183%,20%,93%,N290%,0100%.N staging were 6% (4 / 71) and 21% (15 / 71) respectively. The coincidence rates of T staging in upper rectal segment (12cm), middle segment (7-12cm) and lower segment (0-6cm) were 100% and 74%, respectively. There was no significant difference between the three groups. There was no significant difference in the coincidence rate between the lower rectum and the middle and upper rectum (P0.05). The diagnostic coincidence rate of tumor diameter larger than that of 2cm group was lower than that of 2cm group (57 vs 73%), but the difference was not statistically significant (P0.05). Conclusion the TN staging of rectal cancer is of high value, especially the specificity of early rectal cancer (T1), but the sensitivity to N diagnosis needs to be further improved. In order to improve the clinician's level, select the standard mirror with higher penetration frequency when the focus is larger and lymph node exploration, if necessary, combined with EUS-FNA and other techniques, we can improve the level of preoperative staging of rectal cancer by EUS.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R445.1;R735.37

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相關(guān)期刊論文 前7條

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