摘要
目的探究直肠超声双重造影(Double contrast-enhanced ultrasonography,DCEU)及介入活检一体化检查对直肠癌TN分期(Tumor Node,TN)的临床应用价值。方法选取2017年1月~2019年1月我院接收的直肠癌患者94例,所有患者均接受直肠超声双重造影与介入活检进行检测及病理检测,并分析DCEU及活检一体化对直肠癌T1、T2、T3、T4和N0、N1、N2的准确率及ROC分析结果。结果DCEU及介入活检一体化与手术病理检查结果比较,差异无统计学意义(P>0.05)。DCEU及介入活检一体化的分期诊断率分别为90.91%(10/11)、87.5%(7/8)、84.62%(22/26)、95.92%(47/49),与病理组织学高度一致(Kappa=0.880>0.75),且两种方式T分期的准确性比较,差异无统计学意义(P>0.05)。DCEU及介入活检一体化的分期诊断率分别为82.98%(39/47)、83.87%(26/31)、81.25%(13/16),与病理组织学一致性一般(Kappa=0.618<0.75),且两种方式N分期的准确性比较,差异无统计学意义(P=0.053>0.05)。ROC曲线分析显示,DCEU及介入活检一体化对T1、T4和N2的预测准确度高,对T2和N0的预测准确性良好,对T3和N1的预测准确度低。结论DCEU及介入活检一体化能有效提升对直肠癌TN分期检测的定位与定性,减少诊断时间,为临床治疗提供有价值的参考影像资料。
Objective To investigate the clinical application value of rectal double contrast-enhanced ultrasonography(DCEU)and interventional biopsy in tumor node(TN)staging of rectal cancer.Methods A total of 94 cases of patients with rectal cancer admitted to our hospital from January 2017 to January 2019 were selected.All patients were treated with rectal DCEU and interventional biopsy for detection and pathological examination.Meanwhile,the accuracy and ROC analysis results of DCEU and biopsy integration on T1,T2,T3,T4 and N0,N1,N2 of rectal cancer were analyzed.Results There were no statistically significant differences among the results of the DCEU and interventional biopsy integration and the surgical pathology examination results(P>0.05).The staging diagnostic rates of DCEU and interventional biopsy integration were 90.91%(10/11),87.5%(7/8),84.62%(22/26)and 95.92%(47/49),respectively,which were highly consistent with histopathology(Kappa=0.880>0.75),and there was no statistically significant difference in the accuracy of T staging between the two methods(P>0.05).The staging diagnostic rates of DCEU and interventional biopsy were 82.98%(39/47),83.87%(26/31)and 81.25%(13/16),respectively,which were generally consistent with histopathology(Kappa=0.618<0.75),and there was no statistically significant difference in the accuracy of N staging between the two methods(P=0.053>0.05).ROC analysis showed that DCEU and interventional biopsy integration had high prediction accuracy for T1,T4 and N2,good prediction accuracy for T2 and N0,and low prediction accuracy for T3 and N1.Conclusion The rectal DCEU and interventional biopsy integration can effectively improve the positioning and characterization of TN staging detection of rectal cancer,reduce the diagnosis duration,and provide valuable reference imaging data for clinical treatment.
作者
沈艳
陆文明
郭碧萍
李金晶
茹翱
SHEN Yan;LU Wenming;GUO Biping;LI Jinjing;RU Ao(Department of Ultrasound,the First People's Hospital of Huzhou City in Zhejiang Province,Huzhou313000,China)
出处
《中国现代医生》
2020年第35期120-124,128,F0003,共7页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2019PY015)。
关键词
直肠超声双重造影
介入活检
直肠癌
直肠癌TN分期
Double contrast-enhanced ultrasonography
Interventional biopsy
Rectal cancer
TN staging of rectal cancer
