摘要
目的探讨浸润深度预测评分(DPS)联合超声内镜(EUS)检查对早期胃癌(EGC)浸润深度的诊断价值。方法回顾性分析2017年6月至2019年7月在海军安庆医院行EGC根治术的60例患者的病例资料。分析患者术前EUS检查和DPS评分,与术后病理结果进行比较,分析两者对胃癌浸润深度的判断价值。结果共纳入早期胃癌患者60例(累计病变60例),以术后病理学诊断为金标准,60处病灶中有55例(91.67%)为黏膜层(M)浸润癌,5例(8.33%)为黏膜下层(SM)浸润癌。EUS联合DPS评分诊断EGC浸润深度的准确率、敏感度为95.00%、96.36%,均高于EUS、DPS评分单独诊断,差异有统计学意义(P<0.05);EUS联合DPS评分诊断EGC浸润深度的过度分期率为3.33%低于EUS、DPS评分单独检测的15.00%、23.33%,差异有统计学意义(P<0.05)。单因素分析显示,年龄≥60岁,黏膜发红、表面粗糙、边缘隆起、肿瘤大小、组织学分型和早期胃癌的浸润深度相关,差异均有统计学意义(P<0.05),Logistic回归分析提示,边缘隆起、肿瘤直径≥3 cm是影响结肠癌患者预后的独立危险因素(P<0.05)。结论EUS联合DPS评分可以对EGC的浸润深度提供更准确的判断,为手术方式的选择提供参考。
Objective To explore the diagnostic value of depth-predicting score(DPS)combined with endoscopic ultrasound(EUS)for the detection of depth in early gastric cancer(EGC).Methods A retrospective analysis was performed on the medical data of the 60 patients who underwent EGC radical surgery in the hospital from June 2017 to July 2019.The EUS scores and DPSs before surgery were analyzed and compared with the pathological results after surgery,and analysis was finally made in the diagnostic value of the 2 methods for the detection of infiltration depth of gastric cancer.Results A total of 60 EGC patients(all with cumulative lesions)were included in the study.Postoperative pathological diagnostic results were used as gold standards.Of the 60 lesions,55(91.67%)were of M-layer infiltration cancer,and 5(8.33%)were of SM-layer infiltration cancer.The accuracy and sensitivity of EUS combined with DPS in the diagnosis of EGC infiltration depth were respectively 95.00% and 96.36%,which were superior to those of EUS or DPS alone,with statistical significance(P<0.05).The excessive staging rate of EUS combined with DPS in the diagnosis of EGC infiltration depth was 3.33%,which was lower than that of EUS and DPS alone(15.00%,23.33%),also with statistical significance(P<0.05).Univariate analysis showed that old age(older than 60 years),mucosal redness,rough surface,edge bulge,tumor size and histological type were closely related with the infiltration depth of EGC,also with statistical significance(P<0.05).Logistic regression analysis indicated that edge bulge and tumor size larger than 3 cm were independent risk factors influencing the prognosis of colon cancer patients(P<0.05).Conclusion EUS combined with DPS could predict more accurately the infiltration depth of EGC,which helps to provide reference for the choice of surgical methods.
作者
付鑫
胡炳德
梁丁保
Fu Xin;Hu Bingde;Liang Dingbao(Department of Gastroenterology,Anqing Hospital,PLA Navy,Anqing 246001,China)
出处
《海军医学杂志》
2021年第3期329-333,共5页
Journal of Navy Medicine
关键词
早期胃癌
DPS评分
超声内镜
浸润深度
Early gastric cancer
Depth-predicting score
Endoscopic ultrasound
Infiltration depth
