中国癌症杂志 ›› 2018, Vol. 28 ›› Issue (7): 515-519.doi: 10.19401/j.cnki.1007-3639.2018.07.007

• 论著 • 上一篇    下一篇

直肠腔内三维超声对直肠癌术前分期的诊断价值

张 迅,常 才,王铭河,李佳伟   

  1. 1. 复旦大学附属肿瘤医院超声诊断科,复旦大学上海医学院肿瘤学系,上海 200032 ;
    2. 复旦大学附属肿瘤医院大肠外科,复旦大学上海医学院肿瘤学系,上海 200032
  • 出版日期:2018-07-30 发布日期:2018-08-10
  • 通信作者: 常 才 E-mail: changc61@163.com

Diagnostic value of 3D-transrectal ultrasound in the assessment of preoperative staging of rectal carcinoma

ZHANG Xun1, CHANG Cai1, WANG Minghe2,LI Jiawei1   

  1. 1. Department of Ultrasound, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 2. Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Published:2018-07-30 Online:2018-08-10
  • Contact: CHANG Cai E-mail: changc61@163.com

摘要: 背景与目的:直肠癌是常见的消化道肿瘤,不同分期的肿瘤选择的治疗方式也不相同,而准确的术前分期是指导外科治疗的前提条件。直肠腔内三维超声(3D-transrectal ultrasound,3D-TRUS)检查能清楚地显示5层肠壁结构、直肠周围邻近器官及肠周有无肿大淋巴结,目前被认为是直肠癌术前分期较准确的方法之一,该研究旨在探讨3D-TRUS对直肠癌术前分期的价值。方法:对59例直肠癌患者术前行3D-TRUS检查并作出术前分期,与术后病理分期进行对比。结果:59例直肠癌患者中,3D-TRUS对直肠癌T分期诊断的总准确率为93.2%,与病理T分期的一致性较好(kappa=0.814,P<0.005);3D-TRUS对直肠癌N分期诊断的总准确率为76.3%,与病理N分期的一致性较差(kappa=0.219,P>0.05)。结论:直肠腔内三维超声对直肠癌术前T分期有着较高的准确率,N分期准确率较差,但因为操作简便,患者痛苦少,性价比较高,目前仍是直肠癌术前分期诊断有效的检查方法。

关键词: 直肠癌, 直肠腔内三维超声, 术前分期

Abstract: Background and purpose: Rectal cancer is one of the most common digestive tract malignancies, and treatment is selected according to tumor staging. The accurate preoperative staging is the precondition in guiding rectal cancer surgery. 3D-transrectal ultrasound (3D-TRUS) can clearly show the 5 layer structures of the intestinal wall, the organs adjacent to the rectum and the lymph nodes in the bowel. At present, it is one of the most accurate methods for preoperative staging of rectal cancer. The primary objective of the present study was to evaluate the diagnostic value of 3D-TRUS in the assessment of preoperative staging of rectal carcinoma. Methods: Fifty-nine cases of rectal carcinoma diagnosed clinically were staged preoperatively by 3D-TRUS, and compared with postoperative pathologic staging respectively. Results: The accuracy of 3D-TRUS for T staging was 93.2%. The kappa value was 0.814, which showed considerable consistency (P<0.005). The accuracy of 3D-TRUS for N staging was 76.3%. The kappa value was 0.219, which showed considerable inconsistency (P>0.05). Conclusion: 3D-TRUS is a practical and accurate tool in assessment of preoperative staging of rectal tumors in regard to tumor invasion depth (T) with advantages of simple operation, less pain and high accuracy. However, it is inaccurate in assessing regional lymph node status (N).

Key words: Rectal carcinoma, 3D-transrectal ultrasound, Preoperative staging