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[目的]探讨64排螺旋CT联合血清淀粉样蛋白A(SAA)评估直肠下段癌术前分期的临床价值。[方法]2008年7月～12月于四川大学华西医院肛肠外科住院的119例直肠癌下段患者(肿瘤下缘距齿状线≤7cm),随机分为A组(58例)和B组(61例),A组术前行MSCT和SAA联合评估,B组术前只行MSCT评估。分别比较两组术前分期与术后病理分期。[结果]A组的术前T、N、M、TNM分期的准确度分别为89.7%、86.2%、100.0%和86.2%,B组分别为86.9%、70.5%、100.0%和67.2%。两组间N分期和TNM分期准确度的差异有统计学意义,P值分别为0.038和0.015。[结论]MSCT和SAA联合术前评估,能够提高直肠下段癌患者术前分期的准确性。
[Objective] To investigate the clinical value of 64-slice spiral CT combined with serum amyloid A (SAA) in the evaluation of preoperative staging of lower rectal cancer. [Methods] From January to December 2008, 119 patients with lower rectum cancer (dentate line≤7cm) hospitalized in Department of Anorectal Surgery, West China Hospital of Sichuan University were randomly divided into group A (58 cases) and group B 61 cases), group A preoperative MSCT and SAA joint assessment, group B preoperative MSCT assessment. Preoperative staging and postoperative pathological staging were compared between the two groups. [Results] The accuracy of preoperative T, N, M and TNM staging in group A were 89.7%, 86.2%, 100.0% and 86.2% respectively, while those in group B were 86.9%, 70.5%, 100.0% and 67.2% respectively. There was significant difference between the two groups in the accuracy of N staging and TNM staging, with P values of 0.038 and 0.015, respectively. [Conclusions] The preoperative MSCT and SAA assessment can improve the accuracy of preoperative staging of patients with lower rectal cancer.