Zhu Jiang, Huang Pin-tong, Ding Ke-feng, Zhang Xu, Liu Chun-mei, Liu Xue-ming, Li Bai-zhou, Cai Shan-rong, Zheng Shu
Department of Ultrasound, the Second Affiliated Hospital, Zhejiang University, Hangzhou, China.
Zhonghua Zhong Liu Za Zhi. 2013 Feb;35(2):148-53. doi: 10.3760/cma.j.issn.0253-3766.2013.02.017.
To evaluate the clinical value of radial endorectal ultrasound (ERUS) in the assessment of preoperative staging of rectal carcinoma.
One hundred and ten patients with rectal cancer underwent preoperative endorectal ultrasound (ERUS) examination in our hospital from February 2010 to September 2011. ERUS was performed using a Hitachi 900, Hitachi HI Vision Preirus US scanner, with a 5 - 10 MHz rigid rotating radial transducer and a focal length of 2 - 5 cm. The size, shape, echo pattern, infiltration depth, degree of circumferential involvement, extra-rectal invasion of the lesions and lymph node involvement were observed. The results of ERUS staging were compared with histopathological findings of the surgical specimens.
The accuracy of ERUS for T staging was 91.4%. The accuracy of ERUS in diagnosing stage T1, T2, T3, T4 cancers was 92.7%, 88.2%, 88.2% and 96.4%, respectively. The sensitivity of ERUS in diagnosing stage T1, T2, T3, T4 cancers was 92.3%, 72.7%, 85.4% and 71.4%, respectively. The specificity of ERUS in diagnosing stage T1, T2, T3, T4 cancer was 92.9%, 92.0%, 90.3% and 100.0%, respectively. Comparing the consistency of preoperative T-staging and postoperative pathological results, the Kappa value was 0.75, with a considerable consistency. The sensitivity, specificity, and accuracy of ERUS in the assessment of lymph node metastasis were 74.2%, 89.9% and 85.5%, respectively. Comparing the consistency of preoperative N-staging and postoperative pathological results, the Kappa value was 0.64, with a considerable consistency.
ERUS is a practical and accurate tool in assessment of preoperative staging of rectal tumors in regard to tumor invasion depth (T) and regional lymph node status (N), with advantages of simple operation, less pain, and high accuracy.
评估经直肠超声内镜（ERUS）在直肠癌术前分期评估中的临床价值。
2010年2月至2011年9月，我院110例直肠癌患者接受了术前经直肠超声内镜（ERUS）检查。使用日立900、日立HI Vision Preirus超声扫描仪进行ERUS检查，配备5-10MHz刚性旋转径向探头，焦距为2-5cm。观察病变的大小、形态、回声模式、浸润深度、环周受累程度、直肠外侵犯及淋巴结受累情况。将ERUS分期结果与手术标本的组织病理学结果进行比较。
ERUS对T分期的准确率为91.4%。ERUS诊断T1、T2、T3、T4期癌症的准确率分别为92.7%、88.2%、88.2%和96.4%。ERUS诊断T1、T2、T3、T4期癌症的敏感性分别为92.3%、72.7%、85.4%和71.4%。ERUS诊断T1、T2、T3、T4期癌症的特异性分别为92.9%、92.0%、90.3%和100.0%。比较术前T分期与术后病理结果的一致性，Kappa值为0.75，一致性较好。ERUS评估淋巴结转移的敏感性、特异性和准确率分别为74.2%、89.9%和85.5%。比较术前N分期与术后病理结果的一致性，Kappa值为0.64，一致性较好。
ERUS在评估直肠肿瘤的术前分期中，对于肿瘤浸润深度（T）和区域淋巴结状态（N）是一种实用且准确的工具，具有操作简单、疼痛轻、准确性高的优点。
