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目的探讨超声内镜(EUS)在胃癌术前TN分期中的应用经验。方法术后病理检查证实为胃癌而且使用超声内镜进行了术前TN分期的患者352例,对其资料进行回顾性分析。结果 EUS胃癌术前T分期总正确率为81.25%,其中T1为85.58%,T2为73.91%,T3为82.14%,T4为83.33%,与术后病理结果比较具有高度一致性(Kappa系数为0.75)。EUS对胃癌术前N分期总的正确率为52.84%,其中N0为85.56%,N1为56.69%,N2为28.09%,N3为26.09%,与术后病理结果比较具有一般一致性(Kappa系数为0.33)。将病变部位分为贲门、胃底、胃体、胃窦、幽门,不同部位之间的检测正确率比较,差异无统计学意义(P>0.05)。结论EUS在胃癌术前诊断中具有临床意义,其中T分期可为合理制定治疗方案提供依据,N分期准确性有待提高。
Objective To investigate the application of endoscopic ultrasonography (EUS) in preoperative TN staging of gastric cancer. Methods A total of 352 patients with gastric cancer confirmed by postoperative pathology and who underwent endoscopic TN staging with endoscopic ultrasonography were retrospectively analyzed. Results The total positive rate of preoperative T-staging was 81.25% in EUS gastric cancer, of which T1 was 85.58%, T2 was 73.91%, T3 was 82.14% and T4 was 83.33%, which was highly consistent with postoperative pathological results (Kappa coefficient was 0.75 ). The accuracy of EUS in preoperative N staging of gastric cancer was 52.84%, with N0 85.56%, N1 56.69%, N2 28.09% and N3 26.09%, which was consistent with postoperative pathological results (Kappa coefficient was 0.33). The lesions were divided into cardia, fundus, gastric body, gastric antrum, pylorus, different parts of the detection accuracy, the difference was not statistically significant (P> 0.05). Conclusion EUS has clinical significance in the preoperative diagnosis of gastric cancer. T stage can provide a basis for rational treatment plan, and the accuracy of N stage needs to be improved.