Stepansky Albert, Halevy Ariel, Ziv Yehiel
Division of Surgery, Assaf Harofeh Medical Center, Zerifin, Israel.
Isr Med Assoc J. 2010 May;12(5):270-2.
An accurate preoperative definition of tumor and lymph node status is needed for reaching the correct decision regarding rectal cancer treatment. Transrectal ultrasonography is the most commonly used diagnostic modality for the local staging of rectal cancer.
To determine the accuracy of TRUS in the staging of rectal cancer.
We conducted a retrospective study on 95 patients evaluated by TRUS. The rectum was subdivided into two parts (lower and upper).
Sixty patients underwent radical surgery. Of these, 34 received no preoperative chemo-irradiation owing to microT1, was suggested to patients with adenocarcinoma that proved to be microT3). The overall accuracy rate was 80% for T stage. Overstaging was found in 13.3% and understaging in 6.7%. The N-stage was correctly assessed in 70%. The overall accuracy rate for tumors was 73.9% in the lower part and 90.9% in the upper. A trend towards a lower accuracy rate for low-lying tumors compared to high-located rectal tumors was found (P = 0.532), which did not reach statistical significance.
TRUS gave better results for T1 and T3 stage rectal tumors but was inaccurate for stage T2, indicating the possible need for local excision in order to base the final treatment for T2 tumors on pathologic staging.
为了对直肠癌治疗做出正确决策，需要在术前准确界定肿瘤和淋巴结状态。经直肠超声检查是直肠癌局部分期最常用的诊断方法。
确定经直肠超声检查（TRUS）在直肠癌分期中的准确性。
我们对95例接受TRUS评估的患者进行了一项回顾性研究。将直肠分为两部分（下部和上部）。
60例患者接受了根治性手术。其中，34例因微T1未接受术前化疗放疗（对于腺癌被证实为微T3的患者建议进行术前化疗放疗）。T分期的总体准确率为80%。发现13.3%存在分期过高，6.7%存在分期过低。N分期的正确评估率为70%。肿瘤在下部的总体准确率为73.9%，在上部为90.9%。发现低位肿瘤与高位直肠肿瘤相比，准确率有降低的趋势（P = 0.532），但未达到统计学意义。
TRUS对T1和T3期直肠癌肿瘤的诊断结果较好，但对T2期不准确，这表明可能需要进行局部切除，以便根据病理分期确定T2肿瘤的最终治疗方案。
