论文部分内容阅读
背景与目的:食管癌术前临床分期对选择合理治疗方案至关重要,超声内镜(endoscopicultrasonography,EUS)对食管癌T、N分期诊断准确率高,目前已成为国外食管癌治疗前的常规诊断方法。本研究对食管癌超声内镜检查与手术病理结果进行对照研究,以评价其在食管癌术前临床分期中应用价值。方法:对72例食管癌患者行术前EUS检查及术后病理检查,按UICC(1997)TNM分期标准分期,将EUS分期结果和手术病理分期结果进行对照研究。结果:食管癌术前EUS检查T、N分期的诊断准确率分别为80.6%(58/72)、88.9%(64/72)。T0期诊断准确率为50.0%(2/4),T1期为75.0%(3/4),T2期为70.6%(12/17),T3期为90.0%(36/40),T4期为71.4%(5/7);N0期诊断准确率为92.3%(36/39),N1期为84.8%(28/33),其中纵隔淋巴结和腹部淋巴结诊断准确率分别为90.0%和64.5%。EUST分期、N分期结果与病理分期结果有显著相关性(r=0.687,P<0.001;r=0.776,P<0.001)。EUS检查判断分期不准确的22例中,T分期14例,其中8例难以鉴别T2、T3;N分期8例,其中5例为难以鉴别炎性淋巴结和转移淋巴结。结论:EUS对食管癌术前T、N分期诊断准确率较高,其中对T3期食管癌和纵隔淋巴结诊断价值尤其高;准确鉴别T2和T3分期、转移淋巴结和炎性淋巴结及正确诊断腹部淋巴结转移是提高EUS诊断率的重点和难点。
BACKGROUND & OBJECTIVE: The preoperative staging of esophageal cancer is very important for the selection of a reasonable treatment plan. Endoscopic ultrasound endoscopy (EUS) has a high diagnostic accuracy for T and N stages of esophageal cancer and has now become a routine diagnosis before esophageal cancer treatment abroad method. This study of esophageal ultrasound endoscopy and surgical pathology results were compared to evaluate its value in the preoperative clinical stage of esophageal cancer. Methods: 72 patients with esophageal cancer before operation EUS examination and postoperative pathological examination, according to UICC (1997) TNM staging staging, EUS staging results and surgical pathological staging results were compared. Results: The diagnostic accuracy of preoperative EUS for T and N staging of esophageal cancer were 80.6% (58/72) and 88.9% (64/72), respectively. The diagnostic accuracy rate of T0 was 50.0% (2/4), T1 was 75.0% (3/4), T2 was 70.6% (12/17), T3 was 90.0% (36/40) 71.4% (5/7). The diagnosis accuracy of N0 stage was 92.3% (36/39) and N1 stage was 84.8% (28/33) respectively. The diagnostic accuracy of mediastinal lymph nodes and abdominal lymph nodes were 90.0% and 64.5% respectively. EUST staging, N staging results and pathological staging results were significantly correlated (r = 0.687, P <0.001; r = 0.776, P <0.001). EUS examination to determine the staging inaccurate 22 cases, T staging in 14 cases, of which 8 cases difficult to identify T2, T3; N staging in 8 cases, of which 5 cases were difficult to identify inflammatory lymph nodes and metastatic lymph nodes. Conclusions: EUS has a high diagnostic accuracy for preoperative T and N staging of esophageal cancer, especially for the diagnosis of T3 esophageal cancer and mediastinal lymph nodes. Accurate identification of T2 and T3 staging, metastasis of lymph nodes and inflammatory lymph nodes and correct diagnosis of abdominal lymph nodes Metastasis is to improve the diagnostic rate of EUS focus and difficulty.