摘要
目的探讨超声内镜（EUS）和CT对判断食管癌能否根治性切除的临床价值。方法回顾性分析经手术治疗的746例食管癌患者的临床资料．按术前所行检查分为CT组（480例）、EUS组（151例）和EUS加CT组（115例），采用双盲法，对EUS和CT影像进行回顾性阅片，并将各组结果和手术病理结果进行对照研究。结果CT组、EUS组和EUS加CT组患者的手术根治性切除率分别为91．0％、93．4％和93．9％：3组间差异无统计学意义（X2=1．551，P=0．484）。CT组、EUS组和EUS加CT组术前判断手术根治切除率分别为81．7％、94．7％和96．5％（Xz=15．131，P=0．000；x2=15．662，P=0．000：X2=0．502．P=0．346）；诊断主动脉受侵率分别为91．3％、98．7％和98．3％（X2=9．764，P=0．000；x2=6．659，P=0．004；x2=0．076，P=0．581）；诊断气管支气管受侵率分别为91.3％、96．0％和98．3％（X2=3．729，P=0．034；X2=6．659，P=0．004；X2=1．117，P=0．248）。结论EUS诊断食管癌根治切除和主动脉受侵的临床价值高于CT：EUS和CT诊断气管支气管受侵的价值均较低：与单独应用EUS相比．CT和EUS的联合应用未能显著提高诊断食管癌的根治切除率。
Objective To evaluate the role of endoscopic uhrasonography （EUS） and CT in the prediction of the resectability of esophageal carcinoma. Methods A retrospective study was carried out in 746 patients with esophageal carcinoma. These patients were divided into CT group（480 cases）, EUS group（ 151 cases） and EUS＋CT group（ 115 cases）. Images of EUS and CT were double-blindedly reviewed by radiologists. Relationship of EUS and CT images with surgical and pathological findings was examined. Results Resectation rates in the EUS group, CT group and EUS＋CT group were 93.4%, 91.0% and 93.9%, respectively （x2=1.551, P=0.484）. Accuracy, sensitivity, specificity, positive predictive value and negative predictive value in the CT group were 81.7%, 87.4%, 23.3%, 92.0% and 15.4%, respectively; 94.7%, 98.6%, 40.0%, 95.9% and 66.7% in the EUS group; and 96.5%, 99.1%, 57.1%, 97.3% and 80.0% in the EUS＋CT group, respectively. When assessing aortic invasion, accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 91.3%, 33.3%, 93.1%, 13.5% and 97.7%, in the CT group, respectively; 98.7%, 87.5%, 99.3%, 87.5% and 99.3% in the EUS group, respectively,and 98.3%, 85.7%, 99.1%, 85.7% and 99.1% in the EUS＋CT group, respectively. In assessing tracheobronchial invasion, accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 91.3%, 20.8%, 95.0%, 17.9% and 95.8% in the CT group, respectively; 96.0%, 20.0%, 98.6%, 33.3% and 97.3% in the EUS group, respectively; and 98.3%, 66.7%, 99.1%, 66.7% and 99.1% in the EUS＋CT group. Differences in assessing reseetability were significant between CT group and EUS group （X2=15.131, P=0.000）, between CT group and EUS＋CT group （X2=15.662, P=0.000）, and between EUS group and EUS＋CT group （X2= 0.502, P=0.346）. Differences in assessing aortic invasion were significant between CT group and EUSgroup （X2=9.764, P=0.000）, and between CT group and EUS＋CT group（x2=6.659, P=0.004）, but
出处
《中华胃肠外科杂志》
CAS
北大核心
2010年第3期205-209,共5页
Chinese Journal of Gastrointestinal Surgery
