经腹超声检查在胃癌术前分期中的应用
Transabdominal ultrasonography in preoperative staging of gastric cancer.
作者信息
Liao Sheng-Ri, Dai Ying, Huo Ling, Yan Kun, Zhang Lin, Zhang Hui, Gao Wen, Chen Min-Hua
机构信息
Department of Ultrasonography, School of Oncology, Peking University, Beijing 10036, China.
出版信息
World J Gastroenterol. 2004 Dec 1;10(23):3399-404. doi: 10.3748/wjg.v10.i23.3399.
AIM
To investigate the value of transabdominal ultrasonography (US) in the preoperative staging of gastric cancer.
METHODS
A total of 198 patients with gastric cancer underwent preoperatively transabdominal US, depth of tumor infiltration was assessed in 125 patients, and lymph node metastasis was assessed in 106 patients.
RESULTS
The staging accuracy of transabdominal US was 55.6%, 75.0%, 87.3% and 71.1% in T1, T2, T3 and T4 carcinomas, respectively. The overall accuracy was 77.6%. The detection rate for pancreatic invasion and liver invasion was 77.4%, 71.4%, respectively. The sensitivity, specificity, accuracy of transabdominal US in assessment of lymph node metastasis were 77.6%, 64.1%, 72.6%, respectively. Various shapes such as round, ovoid, spindle were encountered in benign and malignant lymph nodes. Majority of both benign and malignant lymph nodes were hyperechoic and had a distinct border. Benign lymph nodes were smaller than malignant lymph nodes in length and width (P = 0.000, 0.005). Irregular shape, fusional shape, infiltrative signs, inhomogenous echo were seen mainly in malignant lymph nodes (P = 0.045, 0.006, 0.027, 0.006).
CONCLUSION
Transabdominal US is useful for preoperative staging in gastric cancer, although it is difficult to differentiate benign from malignant lymph nodes.
目的
探讨经腹超声检查（US）在胃癌术前分期中的价值。
方法
198例胃癌患者术前行经腹超声检查，其中125例评估肿瘤浸润深度，106例评估淋巴结转移情况。
结果
经腹超声对T1、T2、T3和T4期胃癌的分期准确率分别为55.6%、75.0%、87.3%和71.1%。总体准确率为77.6%。对胰腺侵犯和肝脏侵犯的检出率分别为77.4%、71.4%。经腹超声评估淋巴结转移的敏感性、特异性、准确率分别为77.6%、64.1%、72.6%。良性和恶性淋巴结可见圆形、椭圆形、梭形等多种形态。良性和恶性淋巴结大多为高回声，边界清晰。良性淋巴结的长径和短径均小于恶性淋巴结（P = 0.000，0.005）。不规则形、融合形、浸润征、回声不均匀主要见于恶性淋巴结（P = 0.045，0.006，0.027，0.006）。
结论
经腹超声对胃癌术前分期有一定价值，尽管难以区分良性与恶性淋巴结。
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