Ruf G, Kohlberger E, Rädecke J, Lausen M, Wimmer B
Helv Chir Acta. 1989 Jan;55(5):667-72.
In a prospective study in 49 patients with rectal carcinoma the correlation of pre- and postoperative staging by CT and endorectal ultrasound was proven according to TNM-classification. With CT the pre/postoperative results correlated in T1 in 9/10, in T2 in 10/16, in T3 in 13/15 and in T4 in 6/8 patients. By endorectal ultrasound identical results were found in all T1, in 10/12 T2, in 17/20 T3 and in 6/7 T4 stages. Totally, pre- and postoperative identical results were found by CT in 38 and by endorectal ultrasound in 43/49 patients. Overestimation of the tumor stage was similar with both methods: 5 by CT and 4 by endorectal ultrasound. Underestimation of the stage was more often by CT with 5 than by endorectal ultrasound with 2 cases (CT: accuracy 77.5%, sensitivity 88.3%, specificity 94.4%; endorectal ultrasound: accuracy 87.7%, sensitivity 91.5%, specificity 97.8%). Criteria for interpretation are discussed. In early tumor stages the depth of tumor invasion can be better evaluated by endorectal ultrasound. In late stages both methods give important information for the surgical strategy.
在一项针对49例直肠癌患者的前瞻性研究中，根据TNM分类法证实了CT和直肠内超声对术前和术后分期的相关性。对于CT，术前/术后结果在T1期的10例中有9例相符，T2期的16例中有10例相符，T3期的15例中有13例相符，T4期的8例中有6例相符。通过直肠内超声，在所有T1期、T2期的12例中有10例、T3期的20例中有17例以及T4期的7例中有6例发现了相同结果。总体而言，49例患者中，CT有38例术前和术后结果相同，直肠内超声有43例相同。两种方法对肿瘤分期的高估情况相似：CT有5例，直肠内超声有4例。CT对分期的低估（5例）比直肠内超声（2例）更常见（CT：准确率77.5%，敏感性88.3%，特异性94.4%；直肠内超声：准确率87.7%，敏感性91.5%，特异性97.8%）。文中讨论了解读标准。在肿瘤早期，直肠内超声能更好地评估肿瘤浸润深度。在晚期，两种方法都能为手术策略提供重要信息。
