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目的评价腔内超声对直肠癌术前放化疗后再分期诊断的准确性。方法利用PubMed、EMbase、OVID和WOK数据库,全面检索腔内超声对直肠癌术前放化疗后再分期相关的英文文献,利用SAS和MetaDiSc软件对腔内超声对直肠癌术前放化疗后再分期的敏感性和特异性进行meta分析。结果最终纳入11篇,共651例患者。腔内超声对直肠癌术前放化疗后T3-4分期诊断的敏感性为87.6%(70.9%,95.4%),特异性为66.4%(47.2%,81.4%),诊断比数比(DOR)为17.81(4.03,78.79);对淋巴结阳性诊断的敏感性和特异性,以及DOR分别为49.8%(40.1%,59.5%),78.7%(69.5%,85.7%)和3.96(2.44,6.44)。结论超声对于直肠癌术前放化疗后再分期仍然存在挑战。对于T0-2期的直肠癌,为避免过度扩大切除范围,可以先使用腔内超声对直肠癌进行再分期。不过结果提示部分T0-2期会被过度分期为T3-4期。超声对于直肠癌术前放化疗后的淋巴结的判断不佳。
Objective To evaluate the accuracy of intracavitary sonography in the diagnosis of rectal cancer after chemoradiotherapy. Methods The PubMed, EMbase, OVID and WOK databases were used to search the English literature about intracavitary sonography for the re-staging of rectal cancer before radiotherapy and chemotherapy. SAS and MetaDiSc software were used to analyze the results of intracavitary ultrasound and re-staging The sensitivity and specificity of meta-analysis. The results eventually included 11 articles, a total of 651 patients. The sensitivity, specificity and accuracy of endoscopic ultrasonography for T3-4 staging of patients with rectal cancer were 87.6% (70.9%, 95.4%) and 66.4% (47.2%, 81.4%) respectively. The diagnostic odds ratio (DOR) Was 17.81 (4.03, 78.79). The sensitivity and specificity for positive diagnosis of lymph nodes and DOR were 49.8% (40.1%, 59.5%), 78.7% (69.5%, 85.7%) and 3.96 (2.44,6.44) respectively. Conclusion Ultrasonography still poses a challenge for relapse after preoperative radiochemotherapy in rectal cancer. For T0-2 stage of rectal cancer, in order to avoid excessive expansion of the resection range, you can use intracavity ultrasound re-staging of rectal cancer. However, the results suggest that part of the T0-2 period will be over-staged as T3-4 period. Ultrasound for preoperative radiotherapy and chemotherapy of lymph nodes after the judgment is not good.