【摘要】：目的分析體表超聲在老年原發(fā)性胃癌中的分期診斷價(jià)值及術(shù)前評(píng)價(jià)效果,為臨床診斷與手術(shù)治療提供參考依據(jù)。方法選取經(jīng)胃鏡活檢確診為原發(fā)性胃癌的老年患者100例。所有患者術(shù)前分別采用體表超聲和內(nèi)鏡超聲進(jìn)行檢測(cè),并與手術(shù)病理組織學(xué)檢驗(yàn)結(jié)果進(jìn)行對(duì)照。結(jié)果體表超聲與內(nèi)鏡超聲在胃癌浸潤(rùn)深度T分期檢驗(yàn)的準(zhǔn)確率分別為67.6%和69.5%,兩組間無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),其中體表超聲與內(nèi)鏡超聲T1準(zhǔn)確率分別為54.5%和68.1%、T2準(zhǔn)確率分別為52.4%和57.1%、T3準(zhǔn)確率分別為77.1%和80.0%、T4準(zhǔn)確率分別為86.4%和72.7%,內(nèi)鏡超聲T1準(zhǔn)確率顯著高于體表超聲(P0.05),體表超聲T4準(zhǔn)確率顯著高于內(nèi)鏡超聲(P0.05),但體表超聲與內(nèi)鏡超聲在T2、T3準(zhǔn)確率差異無(wú)統(tǒng)計(jì)學(xué)意義;體表超聲與內(nèi)鏡超聲在胃癌術(shù)前N分期檢驗(yàn)的準(zhǔn)確率分別為82.2%和48.8%,兩組間有統(tǒng)計(jì)學(xué)差異(P0.05),其中體表超聲與內(nèi)鏡超聲N0準(zhǔn)確率分別為72.0%和92.0%、N1準(zhǔn)確率分別為80.0%和48.0%、N2準(zhǔn)確率分別為86.7%和30.0%、N3準(zhǔn)確率分別為90.0%和25.0%,體表超聲在N1、N2、N3分期的準(zhǔn)確率均高于內(nèi)鏡超聲(P0.05),但內(nèi)鏡超聲N0分期準(zhǔn)確率顯著高于體表超聲(P0.05);體表超聲與內(nèi)鏡超聲在胃癌術(shù)前M分期檢驗(yàn)的準(zhǔn)確率分別為90.0%和29.2%,兩組間有統(tǒng)計(jì)學(xué)差異(P0.05),其中體表超聲與內(nèi)鏡超聲M0準(zhǔn)確率分別為100.0%和28.3%、M1準(zhǔn)確率分別為80.0%和30.0%,體表超聲M0、M1分期準(zhǔn)確率均顯著高于內(nèi)鏡超聲(P0.05)。結(jié)論體表超聲和內(nèi)鏡超聲在原發(fā)性胃癌中均有較好的分期診斷價(jià)值,但體表超聲檢查的應(yīng)用價(jià)值顯著高于內(nèi)鏡超聲,具有操作便捷且經(jīng)濟(jì)實(shí)惠的優(yōu)勢(shì),并且能夠反復(fù)使用,患者對(duì)其接受度較高,在術(shù)前胃癌分期診斷中具有更好的應(yīng)用效果。
[Abstract]:Objective to analyze the diagnostic value and preoperative evaluation of body surface ultrasound in elderly patients with primary gastric cancer, and to provide reference for clinical diagnosis and surgical treatment. Methods 100 elderly patients with primary gastric cancer diagnosed by gastroscopy were selected. All patients were examined by body surface ultrasound and endoscopic ultrasonography before operation and compared with the results of histopathological examination. Results the accuracy of body surface ultrasound and endoscopic ultrasonography in T staging of invasive depth of gastric cancer was 67.6% and 69.5%, respectively. There was no significant difference between the two groups (P0.05). The accuracy rate of body surface ultrasound and endoscopic ultrasonography was 54.5% and 68.1% respectively, and the accuracy rate of T _ 2 was 52.4% and 57.1%, respectively, and the accuracy of T _ 3 was 77.1% and 80.0%, respectively. The accuracy rate of T4 was 86.4% and 72.7%, respectively. The accuracy of endoscopic ultrasound T 1 was significantly higher than that of body surface ultrasound (P0.05), the accuracy of body surface ultrasound T 4 was significantly higher than that of endoscopic ultrasound (P0.05), but the accuracy of body surface ultrasound and endoscope ultrasound was significantly higher than that of endoscopic ultrasound (P0.05). There was no significant difference in T3 accuracy. The accuracy of body surface ultrasound and endoscopic ultrasonography in preoperative N staging of gastric cancer was 82.2% and 48.8% respectively, and there was significant difference between the two groups (P0.05). The accuracy of body surface ultrasound and endoscopic ultrasound N0 was 72.0% and 92.0% respectively. The accuracy rate of N1 was 80.0% and 48.0% respectively, and the accuracy of N2 was 86.7% and 30.0%, respectively. The accuracy of N3 staging was 90.0% and 25.0%, respectively. The accuracy of body surface ultrasound in N1N2N3 staging was higher than that of endoscopic ultrasound (P0.05), but the accuracy of endoscopic ultrasound N0 staging was significantly higher than that of body surface ultrasound (P0.05). The accuracy rate of body surface ultrasound and endoscopic ultrasonography in preoperative M staging of gastric cancer was 90.0% and 29.2%, respectively. There was statistical difference between the two groups (P0.05). The accuracy rates of body surface ultrasound and endoscopic ultrasound M0 were 100.0% and 28.3M, respectively. The accuracy of body surface ultrasound M0M 1 staging was significantly higher than that of endoscopic ultrasound (P0.05). Conclusion both body surface ultrasound and endoscopic ultrasound have good diagnostic value in staging of primary gastric cancer, but the application value of body surface ultrasound is significantly higher than that of endoscopic ultrasound, which has the advantages of convenient and economical operation, and can be used repeatedly. The patients have higher acceptance and better results in preoperative diagnosis of gastric cancer staging.
【作者單位】： 濟(jì)源市人民醫(yī)院超聲科;濟(jì)源市婦幼保健院;寧夏醫(yī)科大學(xué);
【基金】：國(guó)家自然科學(xué)基金項(xiàng)目支持(No.81560769)
【分類(lèi)號(hào)】：R445.1;R735.2
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本文編號(hào)：2328082