双重对比增强超声检查提高了胃癌患者 T 分期的诊断准确性，优于多排螺旋 CT。

Double contrast-enhanced ultrasonography improves diagnostic accuracy of T staging compared with multi-detector computed tomography in gastric cancer patients.

机构信息

Department of Ultrasound, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China.

Department of Radiology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China.

出版信息

World J Gastroenterol. 2024 Jun 21;30(23):3005-3015. doi: 10.3748/wjg.v30.i23.3005.

DOI:10.3748/wjg.v30.i23.3005

PMID:38946876

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11212705/

Abstract

BACKGROUND

Gastric cancer (GC) is the most common malignant tumor and ranks third for cancer-related deaths among the worldwide. The disease poses a serious public health problem in China, ranking fifth for incidence and third for mortality. Knowledge of the invasive depth of the tumor is vital to treatment decisions.

AIM

To evaluate the diagnostic performance of double contrast-enhanced ultrasonography (DCEUS) for preoperative T staging in patients with GC by comparing with multi-detector computed tomography (MDCT).

METHODS

This single prospective study enrolled patients with GC confirmed by preoperative gastroscopy from July 2021 to March 2023. Patients underwent DCEUS, including ultrasonography (US) and intravenous contrast-enhanced ultrasonography (CEUS), and MDCT examinations for the assessment of preoperative T staging. Features of GC were identified on DCEUS and criteria developed to evaluate T staging according to the 8 edition of AJCC cancer staging manual. The diagnostic performance of DCEUS was evaluated by comparing it with that of MDCT and surgical-pathological findings were considered as the gold standard.

RESULTS

A total of 229 patients with GC (80 T1, 33 T2, 59 T3 and 57 T4) were included. Overall accuracies were 86.9% for DCEUS and 61.1% for MDCT ( < 0.001). DCEUS was superior to MDCT for T1 (92.5% 70.0%, < 0.001), T2 (72.7% 51.5%, = 0.041), T3 (86.4% 45.8%, < 0.001) and T4 (87.7% 70.2%, = 0.022) staging of GC.

CONCLUSION

DCEUS improved the diagnostic accuracy of preoperative T staging in patients with GC compared with MDCT, and constitutes a promising imaging modality for preoperative evaluation of GC to aid individualized treatment decision-making.

摘要

背景

胃癌（GC）是全球最常见的恶性肿瘤之一，也是癌症相关死亡的第三大原因。在中国，胃癌是一种严重的公共卫生问题，发病率排名第五，死亡率排名第三。了解肿瘤的浸润深度对治疗决策至关重要。

目的

通过与多排螺旋 CT（MDCT）比较，评估双对比增强超声（DCEUS）在术前 T 分期中的诊断性能，用于 GC 患者。

方法

本单前瞻性研究纳入 2021 年 7 月至 2023 年 3 月期间经术前胃镜检查确诊的 GC 患者。患者接受 DCEUS（包括超声和静脉内超声造影）和 MDCT 检查，用于术前 T 分期评估。在 DCEUS 上识别 GC 的特征，并根据 AJCC 癌症分期手册第 8 版制定标准评估 T 分期。通过比较 DCEUS 与 MDCT 的诊断性能，以手术病理结果为金标准。

结果

共纳入 229 例 GC 患者（80 例 T1、33 例 T2、59 例 T3 和 57 例 T4）。DCEUS 的总体准确率为 86.9%，MDCT 为 61.1%（<0.001）。DCEUS 在 T1（92.5%比 70.0%，<0.001）、T2（72.7%比 51.5%，=0.041）、T3（86.4%比 45.8%，<0.001）和 T4（87.7%比 70.2%，=0.022）分期方面优于 MDCT。