导管探头超声内镜对胃癌患者腹水检测的前瞻性评估。

A prospective evaluation of catheter probe EUS for the detection of ascites in patients with gastric carcinoma.

作者信息

Chu Kent-Man, Kwok Ka-Fai, Law Simon, Wong Kam-Ho

机构信息

Current affiliations: Division of Upper Gastrointestinal Surgery, Department of Surgery, University of Hong Kong Medical Center, Queen Mary Hospital, Hong Kong, China.

出版信息

Gastrointest Endosc. 2004 Apr;59(4):471-4. doi: 10.1016/s0016-5107(03)02873-6.

DOI:10.1016/s0016-5107(03)02873-6

PMID:15044880

Abstract

BACKGROUND

Gastric carcinoma is known for its propensity to spread to the peritoneum. This study assessed the value of EUS in the detection of ascites not visible on CT in patients with gastric carcinoma.

METHODS

A total of 402 consecutive patients with histopathologically confirmed gastric adenocarcinoma underwent catheter-probe EUS. The accuracy of catheter-probe EUS in the detection of ascites was compared with subsequent findings at laparoscopy or laparotomy.

RESULTS

There was a slight predominance of men in the study population (M:F=1.6:1). Mean patient age was 65.4+/-0.7 years. Ascites was noted by catheter-probe EUS in 36 patients (9.0%). There was no procedure-related morbidity or mortality. Ascites and peritoneal seeding subsequently were found in, respectively, 56 (13.9%) and 66 (16.4%) patients. The finding of ascites by EUS was significantly related to the presence of peritoneal seeding (p<0.001). The sensitivity, specificity, and positive and negative predictive values of EUS in the detection of ascites were, respectively, 60.7%, 99.4%, 94.4%, and 94.0%. The positive and negative likelihood ratios were, respectively, 105.0: 95% CI[26, 425] and 0.40: 95% CI[0.29, 0.55].

CONCLUSIONS

EUS is useful for the detection of ascites in patients with gastric carcinoma.

摘要

背景

胃癌以易于扩散至腹膜而闻名。本研究评估了超声内镜（EUS）在检测胃癌患者中CT未发现的腹水方面的价值。

方法

共有402例经组织病理学确诊为胃腺癌的连续患者接受了导管探头EUS检查。将导管探头EUS检测腹水的准确性与随后腹腔镜检查或剖腹手术的结果进行比较。

结果

研究人群中男性略占优势（男：女 = 1.6:1）。患者平均年龄为65.4±0.7岁。导管探头EUS检查发现36例患者（9.0%）有腹水。无与操作相关的发病率或死亡率。随后分别在56例（13.9%）和66例（16.4%）患者中发现腹水和腹膜种植。EUS检查发现腹水与腹膜种植的存在显著相关（p<0.001）。EUS检测腹水的敏感性、特异性、阳性和阴性预测值分别为60.7%、99.4%、94.4%和94.0%。阳性和阴性似然比分别为105.0:95%CI[26,425]和0.40:95%CI[0.29,0.55]。