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目的探讨内镜超声(endoscopicultrasonography,EUS)与多层螺旋CT(multi slicespiralCT,MSCT)在胃癌术前T、N分期中的临床应用价值。方法2000年10月至2002年5月,对89例活检证实的胃癌病人术前分别行内镜超声和多层螺旋CT检查,并与手术病理结果对照。结果EUS对胃癌术前T分期的准确率为75.6%,其中T176.5%,T268.8%,T384.4%,T464.7%;MSCT分别79.3%,58.8%,62.5%,90.6%和94.1%。两者差异无统计学意义(P>0.05)。EUS对胃癌术前N分期的准确率为57.5%,其中N095.8%,N145.8%,N232.0%;MSCT分别78.1%,70.8%,75.0%和88.0%。EUS和MSCT对胃癌淋巴结转移的敏感性分别为61.2%和91.8%。EUS对N0分期的准确率显著高于MSCT(P<0.05),MSCT对N和N2分期的准确率及淋巴结转移的敏感性均显著高于EUS(P<0.05,P<0.01,P<0.01)。结论内镜超声检查与多层螺旋CT对胃癌术前TN分期均有较高的准确性。
Objective To investigate the clinical value of endoscopic ultrasonography (EUS) and multi-slice spiral CT (MSCT) in the preoperative T and N staging of gastric cancer. Methods From October 2000 to May 2002, 89 patients with gastric cancer confirmed by biopsy were examined by endoscopic ultrasonography and multi-slice spiral CT before surgery, respectively. Results The accuracy of EUS in preoperative T staging of gastric cancer was 75.6%, among which T176.5%, T268.8%, T384.4%, T464.7%, MSCT 79.3%, 58.8%, 62.5%, 90.6% and 94.1%. There was no significant difference between the two groups (P> 0.05). The accuracy of EUS for preoperative N staging of gastric cancer was 57.5%, of which N095.8%, N145.8% and N232.0%, respectively. MSCT was 78.1%, 70.8%, 75.0% and 88.0% respectively. The sensitivity of EUS and MSCT to lymph node metastasis of gastric cancer were 61.2% and 91.8% respectively. The accuracy of EUS on N0 staging was significantly higher than that of MSCT (P <0.05). The sensitivity of MSCT to the accuracy of N and N2 staging and lymph node metastasis were significantly higher than that of EUS (P <0.05, P <0.01, P <0.01) . Conclusion Endoscopic ultrasonography and multi-slice spiral CT have a high accuracy for preoperative TN staging of gastric cancer.