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目的回顾性评价经内镜超声微探头检查诊断直肠癌T、N分期的准确率和在直肠癌术前分期方面的应用价值。方法使用12MHz超声微探头进行内镜超声检查(EUS)。选择本院手术治疗的53例直肠癌患者在治疗前接受检查。以手术探查和手术后组织病理诊断结果为标准评价内镜超声检查诊断直肠癌肿瘤浸润深度(T分期)的准确率和局部淋巴结转移(N分期)的准确率。结果经内镜超声微探头检查诊断直肠癌T分期的准确率为79.2%,诊断早期直肠癌T分期的准确率为100%,诊断进展期肿瘤(T2～T4)T分期的准确率为75.0%,诊断直肠癌T分期的准确率不受肿瘤部位、形态、浸润直肠壁范围和患者体质指数(BMI)的影响。EUS诊断直肠癌N分期的准确率、灵敏度和特异度分别为65.1%、20.0%和89.3%。结论经内镜超声微探头检查是诊断直肠癌T分期的准确方法,诊断早期直肠癌T分期的应用价值尤为突出,此方法用于直肠癌术前T分期稳定、可靠,但其诊断局部淋巴结转移的准确率较低。
Objective To retrospectively evaluate the accuracy of endoscopic ultrasonography in the diagnosis of rectal cancer T, N staging and its value in the preoperative staging of rectal cancer. Methods A 12 MHz ultrasound microprobe was used for endoscopic ultrasonography (EUS). Fifty-three patients with rectal cancer selected for surgery in our hospital were examined prior to treatment. The accuracy of endoscopic ultrasonography in diagnosing the depth of tumor invasion (T stage) and the accuracy of local lymph node metastasis (N stage) in rectal cancer were evaluated by the results of surgical exploration and postoperative histopathological diagnosis. Results The accuracy of endoscopic ultrasonography in diagnosing rectal cancer was 79.2%, accuracy of T stage in diagnosing early rectal cancer was 100%, and accuracy of T stage in diagnosing advanced tumor was 75.0% The accuracy of T stage in the diagnosis of rectal cancer was not affected by tumor location, morphology, invasive rectal wall area, and patient’s body mass index (BMI). The accuracy, sensitivity and specificity of EUS in the diagnosis of rectal cancer with N staging were 65.1%, 20.0% and 89.3%, respectively. Conclusions Endoscopic ultrasonography is an accurate method for the diagnosis of T staging of rectal cancer. The diagnostic value of T staging for early stage rectal cancer is particularly prominent. This method is reliable and reliable for the preoperative T staging of rectal cancer. However, the diagnosis of local lymph node metastasis The accuracy is lower.