口服对比增强超声在评估胃癌术前 T 分期中的临床应用。
Clinical application of oral contrast-enhanced ultrasound in evaluating the preoperative T staging of gastric cancer.
机构信息
Department of Ultrasound, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan Province, China.
Department of Pathology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan Province, China.
出版信息
World J Gastroenterol. 2024 Nov 7;30(41):4439-4448. doi: 10.3748/wjg.v30.i41.4439.
BACKGROUND
Oral contrast-enhanced ultrasound (OCEUS) is widely used in the noninvasive diagnosis and screening of gastric cancer (GC) in China.
AIM
To investigate the clinical application of OCEUS in evaluating the preoperative T staging of gastric cancer.
METHODS
OCEUS was performed before the operation, and standard ultrasound images were retained. The depth of infiltration of GC (T-stage) was evaluated according to the American Joint Committee on Cancer 8 edition of the tumor-node-metastasis staging criteria. Finally, with postoperative pathological staging as the gold standard reference, the sensitivity, specificity, negative predictive value, positive predictive value, and diagnostic value of OCEUS T staging were evaluated.
RESULTS
OCEUS achieved diagnostic accuracy rates of 76.6% (T1a), 69.6% (T1b), 62.7% (T2), 60.8% (T3), 88.0% (T4a), and 88.7% (T4b), with an average of 75.5%. Ultrasonic T staging sensitivity exceeded 62%, aside from T1b at 40.3%, while specificity was over 91%, except for T3 with 83.5%. The Youden index was above 60%, with T1b and T2 being exceptions. OCEUS T staging corresponded closely with pathology in T4b (kappa > 0.75) and moderately in T1a, T1b, T2, T3, and T4a (kappa 0.40-0.75), registering a concordance rate exceeding 84%.
CONCLUSION
OCEUS was effective, reliable, and accurate in diagnosing the preoperative T staging of GC. As a noninvasive diagnostic technique, OCEUS merits clinical popularization.
背景
口服超声造影（OCEUS）在中国被广泛应用于胃癌（GC）的非侵入性诊断和筛查。
目的
探讨 OCEUS 在评估胃癌术前 T 分期中的临床应用。
方法
在手术前进行 OCEUS，并保留标准超声图像。根据美国癌症联合委员会第 8 版肿瘤-淋巴结-转移分期标准评估 GC 的浸润深度（T 分期）。最后，以术后病理分期为金标准参考，评估 OCEUS T 分期的灵敏度、特异度、阴性预测值、阳性预测值和诊断价值。
结果
OCEUS 对 T1a、T1b、T2、T3、T4a 和 T4b 的诊断准确率分别为 76.6%、69.6%、62.7%、60.8%、88.0%和 88.7%，平均为 75.5%。超声 T 分期的灵敏度除 T1b 为 40.3%外均超过 62%，特异性除 T3 为 83.5%外均超过 91%。Youden 指数均超过 60%，T1b 和 T2 除外。OCEUS T 分期与 T4b 的病理结果密切相关（kappa>0.75），与 T1a、T1b、T2、T3 和 T4a 的病理结果中度相关（kappa 0.40-0.75），符合率超过 84%。
结论
OCEUS 对 GC 术前 T 分期的诊断有效、可靠、准确。作为一种非侵入性诊断技术，OCEUS 值得临床推广。
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