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腹部超声结合CT在胃癌术前分期判断中的应用价值

作者:付华伟 刘发生 吴建刚

所属单位:四川省攀枝花市第二人民医院超声 科 (四川 攀枝花 617068)

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摘要

目的探析腹部超声结合CT在 胃癌术前分期中的应用价值。方法 选 择我院2012年1月-2015年10月收治88例 胃癌患者作为研究对象,均于术前行腹 部超声及多层螺旋CT检查,以病理结果 为基准比较US、MSCT及US+MSCT的术前 分期准确率。结果 US的T分期准确率为 78.4%(69/88),MSCT为81.8%(72/88), US+MSCT为92.0%(81/88),US+MSCT高 于US单独与MSCT单独,差异有统计学 意义(P<0.05);US的N分期准确率为 68.2%(60/88),MSCT为80.7%(71/88), US+MSCT为94.3%(83/88),US+MSCT高 于US单独与MSCT单独,差异有统计学 意义(P<0.05);US的M分期准确率为 64.8%(57/88),MSCT为81.8%(72/88), US+MSCT为93.2%(82/88),US+MSCT高于 US单独与MSCT单独,差异有统计学意义 (P<0.05)。结论 腹部超声结合CT在胃 癌患者临床诊断中的应用具有明显积极 作用,大幅提高术前分期诊断准确性, 可为手术方案的制定提供指导,具有较 大价值。

Objective To explore the application value of abdominal ultrasound combined with CT in the preoperative staging of gastric cancer. Methods 88 cases of patients with gastric cancer treated in our hospital from January 2012 to October 2015 were selected as the research objects. All patients underwent abdominal ultrasound and multi-slice spiral CT examination before operation. The pathological results were taken as the standard to compared the accuracy rates of US, MSCT and US+MSCT in preoperative staging. Results The accuracy rates of US, MSCT and US combined with MSCT in T staging were 78.4% (69/88), 81.8% (72/88) and 92.0% (81/88), respectively. That of US combined with MSCT was higher than that of US alone and MSCT alone (P<0.05); The accuracy rates of US, MSCT and US combined with MSCT in N staging were 68.2% (60/88), 80.7% (71/88) and 94.3% (83/88), respectively. That of US combined with MSCT was higher than that of US alone and MSCT alone (P<0.05); The accuracy rates of US, MSCT and US combined with MSCT in M staging were 64.8% (57/88), 81.8% (72/88) and 93.2% (82/88), respectively. That of US combined with MSCT was higher than that of US alone and MSCT alone (P<0.05). Conclusion The application of abdominal ultrasound combined with CT in clinical diagnosis of patients with gastric cancer has significant positive effect. It greatly improves the accuracy rate of preoperative staging diagnosis and can provide guidance for the development of operation plan. It is of great value

【关键词】胃癌;术前分期;腹部超声;CT

【中图分类号】R445.1;R445.3

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.04.034

前言

胃癌为胃肠道常见恶性肿瘤,死亡率居恶性肿瘤首位[1]。其临 床治疗以手术为主,为帮助患者选择最佳手术方式,术前进行准确 分期极为重要。在影像学技术的不断进步下,腹部超声(Abdominal ultrasound,US)与多层螺旋CT(multislice CT,MSCT)在胃癌术前临 床分期诊断中均得到广泛应用,取得不错效果。但大量临床研究显示 [2-3],单一诊断方法存在一定不足,要想进一步提高胃癌患者的术前分 期准确率,可采取两种检查方法结合的方式。超声在判断胃癌侵犯深 度与临床分期方面发挥重要作用,MSCT对于胃癌侵犯深度、周围脏器 受侵犯情况及腹腔脏器与腹腔淋巴结转移情况的显示较佳,因而N分期 与M分期诊断率较高。本研究以我院收治胃癌患者为例,探析腹部超声 结合CT在胃癌术前分期中的应用价值,现报道如下。