摘要
目的明确超声内镜对早期胃癌浸润深度的诊断价值及其影响因素。方法回顾性分析2010年12月至2018年12月行内镜黏膜下剥离术并确诊为早期胃癌(包括高级别上皮内瘤变)的170例患者的临床、内镜及病理资料,包括年龄、性别、病变部位、内镜分型、病变直径、黏膜凹陷、溃疡、浸润深度、病理类型等,所有患者术前均行超声内镜,以术后病理浸润深度作为诊断金标准,比较超声内镜与病理结果是否一致,分析其诊断价值及影响因素。结果超声内镜对早期胃癌浸润深度诊断的总体准确率为74.1%,对黏膜层诊断的敏感性、特异性、阳性预测值及阴性预测值分别为74.8%、66.7%、95.9%和20.4%。多因素分析发现黏膜凹陷是影响超声内镜诊断准确性的独立危险因素(P<0.05)。结论超声内镜可以作为诊断早期胃癌浸润深度的一种检查方法,对于伴有黏膜凹陷的病变,其诊断准确性可能会有所降低。
Objective To determine the value of endoscopic ultrasonography(EUS)in diagnosis of invasive depth of early gastric cancer(EGC)and its influencing factors.Methods The clinical and pathological data of 170 patients with EGC(including high-grade intraepithelial neoplasia)who underwent endoscopic submucosal dissection between December 2010 and December 2018 were retrospectively analyzed,including age,gender,lesion site,endoscopic classification,lesion diameter,mucosal pits,ulcers,invasive depth and pathological types.All patients underwent EUS before surgery.Using pathological invasive depth as the diagnostic gold standard,the ultrasonic findings were compared with the pathological results to analyze the diagnostic value and influencing factors of EUS.Results The overall accuracy of EUS in diagnosing invasive depth was 74.1%.The sensitivity,specificity,positive predictive value and negative predictive value of EUS in diagnosis of mucous membrane were 74.8%,66.7%,95.9%and 20.4%,respectively.Multivariate analysis revealed that mucosal depression was an independent risk factor affecting the accuracy of EUS(P<0.05).Conclusion EUS can be used to diagnose the invasive depth of EGC.However,the diagnostic accuracy may decreased in lesions with mucosal pits.
作者
徐瑶
王志洋
罗凌玉
黄德强
XU Yao;WANG Zhi-yang;LUO Ling-yu;HUANG De-qiang(Department of Gastroenterology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)
出处
《实用临床医学（江西）》
CAS
2020年第4期5-9,共5页
Practical Clinical Medicine
关键词
超声内镜
早期胃癌
浸润深度
endoscopic ultrasonography
early gastric cancer
invasive depth
