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目的对比微探头超声内镜(MCUS)及CT在胸段食管癌术前进行T、N分期中的应用价值,探讨MCUS判断淋巴结转移的标准。方法对35例初治胸段食管癌患者分别进行MCUS扫描和CT扫描,并同时分别进行T、N分期;以术后病理为金标准,比较在对淋巴结转移的判断中,本研究试行的3种标准的准确率(即真实性)、灵敏度、特异度、阳性及阴性预测值等参数,判断其临床应用价值,并且,就MCUS扫描对淋巴结转移的判断标准进行探讨。结果本组35例中,MCUS的T分期准确率(85.7%)高于CT(45.7%),差异有统计学意义(P=0.000);MCUS的N分期中,两种标准的准确率(分别为85.7%及80.0%)均略高于CT(74.3%),但差异无统计学意义(P>0.05)。应用淋巴结短径及短长轴比例(S/L)结合的方法,研究结果显示,检测的灵敏度有所提高。结论MCUS在胸段食管癌术前分期中有重要作用,其T分期准确率明显高于传统CT扫描。以淋巴结短径与S/L结合进行分析,有望提高判断淋巴结转移的准确性。
Objective To compare the value of micro-probe endoscopic ultrasonography (MCUS) and CT in the preoperative T, N staging of thoracic esophageal cancer and to explore the criteria of MCUS in determining lymph node metastasis. Methods 35 cases of newly diagnosed thoracic esophageal cancer patients were performed MCUS scan and CT scan, respectively, while T, N staging; postoperative pathology as the gold standard, compared with the judgment of lymph node metastasis, the pilot study 3 The standard accuracy (ie, authenticity), sensitivity, specificity, positive and negative predictive value and other parameters to determine the clinical value, and MCUS scan lymph node metastasis to determine the criteria for discussion. Results The accuracy of T stage (85.7%) in MCUS was higher than that in CT (45.7%) in 35 cases (P = 0.000). In the N stage of MCUS, the accuracy of the two criteria 85.7% and 80.0% respectively) were slightly higher than that of CT (74.3%), but the difference was not statistically significant (P> 0.05). Using the combination of lymph node short diameter and short axis ratio (S / L), the results showed that the sensitivity of detection increased. Conclusion MCUS plays an important role in preoperative staging of thoracic esophageal cancer, and the accuracy of T stage is obviously higher than that of traditional CT scan. With lymph node short diameter and S / L binding analysis, is expected to improve the accuracy of the judgment of lymph node metastasis.