摘要
目的:探讨胃双重超声造影(DCEUS)联合血清巨噬细胞炎症蛋白1(MIP-1)与血管细胞黏附分子1(VCAM-1)检测对胃癌术前分期的临床价值。方法:685例胃癌患者术前行胃镜和DCEUS检查并进行术前分期,同时运用ELISA法检测术前血清MIP-1与VCAM-1水平,根据术后病理分期,比较DCEUS与DCEUS联合MIP-1与VCAM-1检测对胃癌术前分期判断准确性。结果:DCEUS对胃癌T分期判断的敏感性(特异性)分别为T1 93.10%(92.05%)、T2 67.47%(65.50%)、T3 78.62%(80.47%)、T4 91.41%(90.70%),总准确率为80.15%;对N分期判断的敏感性(特异性)分别为N0 90.55%(80.99%)、N1 63.57%(73.87%)、N2 88.40%(92.50%)、N3 82.35%(73.68%),总准确率为82.92%;对M分期判断的敏感性(特异性)分别为:M0 99.29%(84.82%)、M1 71.48%(98.43%),总准确率为88.61%。血清MIP-1和VCAM-1水平与胃癌组织浸润程度、淋巴结转移、远处转移和病理分期均有关(均P<0.05)。DCEUS联合MIP-1、VCAM-1检测对T分期判断的敏感性(特异性)分别为T1 93.10%(92.05%)、T2 87.95%(94.19%)、T3 95.07%(92.33%)、T4 91.41%(90.70%),总准确率为92.41%;对N分期判断的敏感性(特异性)分别为:N0 98.43%(96.90%)、N1 89.15%(94.26%)、N2 95.22%(95.22%)、N3 92.65%(89.36%),总准确率为94.16%;对M分期判断的敏感性(特异性)分别为M0 99.76%(97.68%)、M1 96.20%(99.61%),总准确率为98.39%。DCEUS联合MIP-1、VCAM-1检测对判断胃癌T、N、M分期的准确率均明显高于DCEUS(均P<0.05)。结论:胃癌的病理分期与血清MIP-1和VCAM-1表达密切相关,DCEUS联合术前检测MIP-1和VCAM-1血清水平,有利于提高胃癌术前分期判断的准确性。
Objective： To assess the clinical value of double contrast-enhanced ultrasonography（DCEUS） of the stomach combined with determination of serum macrophage inl ammatory protein 1（MIP-1） and vascular cell adhesion molecule 1（VCAM-1） in preoperative staging for gastric cancer. Methods： Six-hundred and eighty-five patients with gastric cancer underwent gastroscopy and DCEUS examination for preoperative staging, and meanwhile, their preoperative MIP-1 and VCAM-1 levels were measured by ELISA assay. According to the results of postoperative pathological tumor staging, the accuracy in preoperative stage estimation of gastric carcinoma between DCEUS and DCEUS plus MIP-1 and VCAM-1 measurement was compared.Results： The sensitivity（specificity） of DCEUS in estimating T stage of gastric cancer was 93.10%（92.05%） for T1, 67.47%（65.50%） for T2, 78.62%（80.47%） for T3 and 91.41%（90.70%） T4 respectively, with an overall accuracy rate of 80.15%, in estimating N stage was 90.55%（80.99%） for N0, 63.57 %（73.87%） for N1, 88.40%（92.50%） for N2 and 82.35%（73.68%） for N3 respectively, with an overall accuracy rate of 82.92%, and in estimating M stage was 99.29%（84.82%） for M0 and 71.48%（98.43%） for M1 respectively, with an overall accuracy rate of 88.61%. Both serum levels of MIP-1 and VCAM-1 were significantly related to the degree of invasion, lymphatic metastasis, distant metastasis and pathological stage of gastric carcinoma（all P〈0.05）. h e sensitivity（specii city） of DCEUS plus MIP-1 and VCAM-1 measurement in estimating T stage of gastric cancer was 93.10%（92.05%） for T1, 87.95%（94.19%） for T2, 95.07%（92.33%） for T3 and 91.41%（90.70%） for T4 respectively, with an overall accuracy rate of 92.41%, in estimating N stage was 98.43%（96.90%） for N0, 89.15%（94.26%） for N1, 95.22 %（95.22%） for N2 and 92.65%（89.36%） for N3 respectively, with an overall accuracy rate of 94.16%, and in estimating M stage was 99.76%（97.68%） for M0 and 96
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2016年第4期573-580,共8页
China Journal of General Surgery
关键词
胃肿瘤
肿瘤分期
超声检查
巨噬细胞炎性蛋白质类
血管细胞黏附分子1
Stomach Neoplasms
Neoplasm Staging
Ultrasonography
Macrophage Inflammatory Proteins
Vascular Cell Adhesion Molecule-1
