| 摘要: |
| 目的探讨超声内镜（EUS）对胃癌患者术前T、N分期准确率的评估效果及其影响因素。方法收集2014年1月至2016年1月术前接受EUS检查的233例胃癌患者的资料，以术后病理分期为金标准，分析术前EUS分期的准确率，并采用多因素logistic回归分析病灶部位、类型、组织学分型、病灶直径、病变处胃壁厚度与EUS分期准确率的关系。结果病变位于胃窦部最多，占39.6%，其次是胃体；病变类型以BorrmannII型溃疡型最多，占39.5%；术后病理组织学类型以低分化腺癌为多，占50.9%。EUS对T、N分期的总准确率分别为83.8%、63.7%。病变部位、类型、胃壁最大厚度及最大直径对T分期准确率均有明显影响（P＜0.05或0.01），而组织学类型的影响不明显（P＞0.05）；病变处胃壁最大厚度对N分期的准确率也有明显影响（P＜0.05），而病变部位、类型、最大直径及组织学类型的影响均不明显（均P＞0.05）。结论EUS判断胃癌术前分期受多种因素影响，T分期的准确率受病变部位、浸润深度的影响，而N分期的准确率受病变浸润深度的影响。 |
| 关键词: 胃癌 超声内镜 术前分期 病理分期 |
| DOI：10.12056/j.issn.1006-2785.2017.40.3.2017-755 |
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| Accuracy of endoscopic ultrasonography in preoperative staging for patients with gastric cancer and its influencing factors |
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the First Affiliated Hospital，Zhejiang University School of Medicine
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| Abstract: |
| Objective To evaluate the accuracy of endoscopic ultasonography (EUS) in preoperative staging for patients with gastric cancer and its influencing factors. Methods The clinical data and EUS findings of 233 patients with gastric cancer treated in Wenling People's Hospital from January 2014 to January 2016 were retrospectively analyzed. The postoperative TNM staging was used as golden standard, and the accuracy of preoperative EUS was evaluated. Results The overall accuracy rate of preoperative T staging by EUS was 83.8%, and the accuracy was associated with Borrman type, logitudinal portions, tumor size, tumor invasion depth and gastric wall thickness (P＜0.05) , and not affected by histological types (P ＞0.05). The accuracy rate for preoperative N staging was relatively low (63.7%), which was mainly affected by gastric wall thickness and tumor invasion depth (P＜0.05). Multivariate logistic regression showed that Borrman type, logitudinal portions, tumor size, tumor invasive depth were independent factors affecting the accuracy of preoperative T staging by EUS (P ＞0.05). Conclusion The accuracy of
preoperative T staging of gastric cancer by EUS is affected by tumor location, type, size and invasion depth; and the accuracy of N staging is associated with tumor invasion depth. |
| Key words: Gastric tumor Endoscopic ultrasonography Pathologic staging Preoperative staging |
