Service of Digestive Disease, Complejo Hospitalario Xeral-Cíes, Complejo Hospitarlario Universitario de Vigo, Pontevedra, Spain.
Rev Esp Enferm Dig. 2009 Nov;101(11):773-86. doi: 10.4321/s1130-01082009001100005.
This study compared the accuracy of ultrasonography in the diagnosis of gastrointestinal tumors in patients with several degrees of clinical suspicion.
We recruited patients that were suspect for gastrointestinal neoplasia but with no evidence of localizing symptoms (group A), and patients that were suspect for colon cancer (group B) or for gastric cancer (group C). Accuracy in the diagnosis was compared for: gastric cancer in groups A and C, and for colon cancer in groups A and B. The comparison was made by using the contingency coefficient, which quantifies coincidence of endoscopic and ultrasonographic diagnoses.
Seventy-nine patients were included in group A (48 males), wherein 12 colon and 5 gastric neoplasms were detected. Group B was comprised of 153 patients (78 males) and included 66 patients with colorectal cancer (CCR). Group C contained 58 patients (35 males), 31 of whom were diagnosed with gastric cancer. The accuracy of sonography for diagnosing colon cancer was 95.5% for group A and 87.5% for group B. The contingency coefficient for endoscopy vs. ultrasonography was greater for group A: 0.658 than for group B: 0.549. The diagnostic accuracy for gastric cancer was 97.4% for group A and 86.2% for group C. The contingency coefficient between endoscopic and ultrasonographic diagnoses was also greater in group A (0.618) than in group C (0.588).
The accuracy of ultrasonography in diagnosing colon and gastric cancer is not lower in patients without localizing symptoms.
本研究比较了超声诊断不同程度临床怀疑胃肠道肿瘤的准确性。
我们招募了怀疑患有胃肠道肿瘤但无局部症状证据的患者(A 组),以及怀疑结肠癌(B 组)或胃癌(C 组)的患者。比较了 A 组和 C 组胃癌、A 组和 B 组结肠癌的诊断准确性。采用列联系数比较内镜和超声诊断的一致性,列联系数定量评估内镜和超声诊断的一致性。
A 组共纳入 79 例患者(男 48 例),其中发现 12 例结肠和 5 例胃肿瘤。B 组共纳入 153 例患者(男 78 例),其中 66 例为结直肠癌(CRC)。C 组包含 58 例患者(男 35 例),其中 31 例诊断为胃癌。超声诊断结肠癌的准确性在 A 组为 95.5%,在 B 组为 87.5%。A 组内镜与超声诊断的列联系数为 0.658,B 组为 0.549,A 组大于 B 组。A 组诊断胃癌的准确性为 97.4%,C 组为 86.2%。A 组内镜与超声诊断的列联系数(0.618)也大于 C 组(0.588)。
在无局部症状的患者中,超声诊断结肠癌和胃癌的准确性并不低。