Kim N K, Choi J S, Sohn S K, Min J S
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 1994 Dec;35(4):396-403. doi: 10.3349/ymj.1994.35.4.396.
A precise knowledge of the depth of invasion of tumor is essential for the planning of treatment of rectal cancer. Transrectal ultrasonography is a new diagnostic modality that has become useful in determining the depth of invasion preoperatively and the presence or absence of metastatic lymph nodes. Transrectal ultrasonography was used in preoperative staging of 36 patients with rectal cancer. Thirty three patients had a radical resection (17 low anterior resection, 15 abdominoperineal resection and 1 pelvic exenteration), one patient had a local excision. Two among these thirty four patients had preoperative radiotherapy. Preoperative transrectal ultrasonographic staging was compared with pathologic findings. In staging depth of invasion, the overall accuracy was 88.8 percent, overstaged in 5.8 percent, understaged in 5.8 percent. Transrectal ultrasonography is the more accurate method than CT in staging of depth of tumor invasion (61.8% vs 88.8%). In staging of lymph nodes, the overall accuracy of transrectal ultrasonography was 85.3 percent, sensitivity was 71.7 percent and specificity was 88.8 percent. Transrectal ultrasonography is a safe, inexpensive and accurate staging method in the assessment of both depth of invasion and nodal status.
准确了解肿瘤浸润深度对于直肠癌治疗方案的制定至关重要。经直肠超声检查是一种新的诊断方法，已在术前确定肿瘤浸润深度及有无转移性淋巴结方面发挥了作用。对36例直肠癌患者进行了术前经直肠超声检查分期。33例患者接受了根治性切除术（17例低位前切除术、15例腹会阴联合切除术和1例盆腔脏器清除术），1例患者接受了局部切除术。这34例患者中有2例接受了术前放疗。将术前经直肠超声检查分期与病理结果进行比较。在肿瘤浸润深度分期方面，总体准确率为88.8%，高估5.8%，低估5.8%。在肿瘤浸润深度分期方面，经直肠超声检查比CT更准确（61.8%对88.8%）。在淋巴结分期方面，经直肠超声检查的总体准确率为85.3%，敏感性为71.7%，特异性为88.8%。经直肠超声检查在评估肿瘤浸润深度和淋巴结状态方面是一种安全、廉价且准确的分期方法。
