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目的探讨经腹超声检查(transabdominalultrasonography,TAUS)对胃癌术前TNM分期和血管生成的评估价值。方法对64例胃癌患者术前行经腹超声检查,其中37例行经腹彩色多普勒超声检查,测定胃癌的彩色多谱勒血管指数(colorDopplervascularityindex,CDVI);并采用抗CD34抗体,通过免疫组织化学染色检测胃癌组织的微血管密度(microvesseldensity,MVD)。结果TAUS对胃癌T分期的判断准确率为56.0%,其中T12/3例,T228.6%,T373.1%,T450.0%;对胃癌淋巴结状况判断的总体准确率为63.3%,对淋巴结转移判断的敏感性和特异性分别为37.9%和100%。TAUS对胃癌N分期的判断准确率为57.1%,其中N0100%,N116.7%,N235.3%;对胃癌远处转移判断的敏感性和特异性分别为58.3%和100%。通过彩色多普勒超声检查测定的胃癌CDVI与血管浸润显著相关(P=0.0418),回归分析同时显示CDVI与MVD呈线性相关(r=0.5628,P<0.01)。结论TAUS可作为胃癌患者术前的常规检查。
Objective To evaluate the value of transabdominal ultrasonography (TAUS) in assessing preoperative TNM staging and angiogenesis in gastric cancer. Methods Totally 64 gastric cancer patients underwent transabdominal ultrasonography before operation. Among them, 37 cases underwent color Doppler vascular index (CDVI) by transabdominal color Doppler echocardiography. The anti-CD34 antibody was used to detect the color Doppler vascularity index (CDVI) Chemical staining was used to detect microvessel density (MVD) in gastric cancer tissues. Results The accuracy of TAUS in diagnosing gastric cancer T stage was 56.0%, of which T12 / 3 cases, T228.6%, T373.1% and T450.0%. The overall accuracy of TAUS in diagnosing gastric cancer was 63.3% The sensitivity and specificity of metastasis judgment were 37.9% and 100% respectively. The accuracy of TAUS in diagnosing gastric cancer staging was 57.1%, of which N0100%, N116.7% and N235.3%. The sensitivity and specificity of TAUS in predicting the distant metastasis of gastric cancer were 58.3% and 100%, respectively. CDVI was significantly correlated with vascular invasion (P = 0.0418) by color Doppler sonography. Regression analysis also showed a linear correlation between CDVI and MVD (r = 0.5628, P <0.01). Conclusion TAUS can be used as a routine preoperative examination of gastric cancer patients.