疑难病杂志2017，Vol.16Issue(11)：1104-1108,5.DOI:10.3969/j.issn.1671-6450.2017.11.007
线阵超声内镜联合CT对中晚期胃癌患者术前TN分期的临床诊断价值
Clinical diagnostic value of linear endoscopic ultrasonography combined CT examination for middle and late stage gastric cancer preoperative TN staging
摘要
Abstract
Objective To evaluate the clinical value and the reasonable combination way through the linear array endoscopic ultrasonography (LEUS) and total abdominal CT examination for locally advanced gastric cancer treatment TN staging.Methods Collected from January 2014 to November 2016,in the Department of Gastroenterology,the second hospital of Hebei Medical University,73 patients with gastric cancer underwent endoscopic biopsy or fine needle aspiration biopsy (EUS FNA) were enrolled,preoperative LEUS examination and abdominal CT examination for the diagnosis of TN staging and postoperative pathology results of comparative analysis were performed.Results Comparison of LEUS and pathology after operation,the diagnostic accuracy of T1,T2,T3,T4 were 80.0％,77.3％,71.4％,60.0％;compared with postoperative pathological CT,the diagnostic accuracy of T1,T2,T3 and T4 were 60.0％,63.6％,76.2％,66.7％.Comparison of LEUS and pathology after operation,the diagnostic accuracy of N0,N1,N2 and N3 were 86.7％,76.5％,45.5％,63.2％;compared with postoperative pathological CT,the diagnostic accuracy of N0,N1,N2 and N3 were 80.0％,70.6％,63.6％,94.7％.LEUS combined with CT and postoperative pathological diagnosis of T1,T2,T3 comparison,the sensitivity of T4 was 80.0％,77.3％,76.2％,66.7％,the specificity was 98.3％,90.2％,82.7％,94.8％,the accuracy rate was 94.5％,86.3％,80.8％,89.0％.The Kappa test was highly consistent (Kappa =0.726),and the area under the ROC curve (AUC) had higher accuracy (AUC =0.958).LEUS combined with CT and postoperative pathological diagnosis of N0,N1,N2 comparison,the sensitivity of N3 was 86.7％,76.5％,63.6％,94.7％,the specificity was 98.3％,92.9％,92.2％,88.9％,the accuracy rate was 95.9％,89.0％,83.6％,90.4％,the Kappa test has a high degree of consistency (Kappa =0.725),ROC curve under (AUC) with high accuracy (AUC =0.972).Conclusion The combination of LEUS and CT has good consistency and accuracy in postoperative pathological diagnosis.It can be used as a preoperative method to judge TN staging of gastric cancer.关键词
线阵超声内镜/计算机X射线断层扫描/胃癌/TN分期Key words
Linear endoscopic ultrasonography/Computed tomography/Gastric cancer/TN staging system引用本文复制引用
徐晓云,周立霞,李冬斌,石亮,杨川杰..线阵超声内镜联合CT对中晚期胃癌患者术前TN分期的临床诊断价值[J].疑难病杂志,2017,16(11):1104-1108,5.基金项目
河北省卫生计生委项目(ZL20140273) （ZL20140273）
