Yan Chao, Zhu Zheng-gang, Zhu Qi, Yan Min, Chen Jun, Liu Bing-ya, Yin Hao-ran, Lin Yan-zhen
Department of General Surgery, Ruijin Hospital, Shanghai Second Medical University, Shanghai Institute of Digestive Surgery, Shanghai 200025, China.
Zhonghua Zhong Liu Za Zhi. 2003 Jul;25(4):390-3.
To study the clinical value of endoscopic ultrasonography (EUS) in the preoperative staging of early gastric carcinoma.
EUS was performed in 149 gastric carcinoma patients proved by biopsy (including 33 patients with early gastric cancer), of which the results were compared with postoperative pathologic findings.
The accuracy of EUS in determining the T stage of gastric carcinoma was 80.3% (T1 81.8%, T2 70.4%, T3 88.9%, T4 71.4%). The accuracy of EUS in differentiating early gastric carcinoma from advanced ones was 95.1%, and the accuracy of EUS in differentiating mucosal cancer from submucosal cancer was only 63.6%. The diagnostic accuracy of EUS for mucosal and submucosal cancer was 52.9% and 75%, with positive predictive value of 90% and 70.6%, respectively. The accuracy of invasion depth of EUS for the bulging and flat type of early gastric carcinoma was 100%, whereas the accuracy was only 58.6% for the depressed type. The accuracy of invasion depth of the differentiated and undifferentiated early cancer was 71.4%and 57.9%, without any significant difference (P > 0.05). The accuracy of invasion depth of EUS for early gastric carcinoma decreased as tumor size increased. The diagnostic accuracy of lymph node status of early gastric carcinoma by EUS was 90.9%, and the sensitivity and specificity of lymph node metastasis was 66.7% and 96.3%, respectively.
The clinical value of endoscopic ultrasonography in the preoperative staging of early gastric carcinoma is relatively high.
探讨内镜超声检查（EUS）在早期胃癌术前分期中的临床价值。
对149例经活检证实的胃癌患者（其中包括33例早期胃癌患者）进行EUS检查，并将结果与术后病理结果进行比较。
EUS判断胃癌T分期的准确率为80.3%（T1期81.8%，T2期70.4%，T3期88.9%，T4期71.4%）。EUS鉴别早期胃癌与进展期胃癌的准确率为95.1%，而鉴别黏膜癌与黏膜下癌的准确率仅为63.6%。EUS对黏膜癌和黏膜下癌的诊断准确率分别为52.9%和75%，阳性预测值分别为90%和70.6%。EUS对隆起型和浅表型早期胃癌浸润深度的准确率为100%，而对凹陷型早期胃癌浸润深度的准确率仅为58.6%。高分化和未分化早期胃癌浸润深度的准确率分别为71.4%和57.9%，差异无统计学意义（P>0.05）。EUS对早期胃癌浸润深度的准确率随肿瘤大小增加而降低。EUS对早期胃癌淋巴结状态的诊断准确率为90.9%，对淋巴结转移的敏感度和特异度分别为66.7%和96.3%。
内镜超声检查在早期胃癌术前分期中具有较高的临床价值。
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