Orrom W J, Wong W D, Rothenberger D A, Jensen L L, Goldberg S M
Division of Colon and Rectal Surgery, University of Minnesota, Minneapolis 55455.
Dis Colon Rectum. 1990 Aug;33(8):654-9. doi: 10.1007/BF02150740.
The preoperative staging of rectal cancer has important implications for treatment as local therapies become increasingly utilized. Seventy-seven patients underwent preoperative staging using endorectal ultrasonography. All patients had complete pathologic staging and none had preoperative radiotherapy. Depth of invasion of the tumor was accurately predicted in 75 percent of cases in the entire group, with 22 percent overstaged and 3 percent understaged. Accuracy improved greatly over the study period, and in the past six months, 95 percent have been accurately staged for depth of invasion with 5 percent overstaged. Lymph nodes have been properly classified into positive and negative groups in 88 percent of cases in the past year, with a specificity of 90 percent and a sensitivity of 88 percent. Endorectal ultrasound is an accurate preoperative staging modality. Accuracy is improved greatly with increased experience and it has been found that the 5-layer anatomical model facilitates accurate staging. Introduction of the ultrasound probe through a previously placed proctoscope ensures complete scanning of the entire lesion and should be used for the majority of examinations.
随着局部治疗方法的使用越来越多，直肠癌的术前分期对治疗具有重要意义。77例患者接受了直肠内超声检查进行术前分期。所有患者均有完整的病理分期，且均未接受术前放疗。在整个组中，75%的病例肿瘤浸润深度被准确预测，22%分期过高，3%分期过低。在研究期间，准确性有了很大提高，在过去六个月中，95%的病例浸润深度分期准确，5%分期过高。在过去一年中，88%的病例淋巴结被正确分为阳性和阴性组，特异性为90%，敏感性为88%。直肠内超声是一种准确的术前分期方法。随着经验的增加，准确性有了很大提高，并且发现五层解剖模型有助于准确分期。通过先前放置的直肠镜插入超声探头可确保对整个病变进行完整扫描，并且应在大多数检查中使用。
