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目的:探讨超声内镜(EUS)在直肠癌术前TNM分期及术后局部复发的诊断价值。方法:对112例手术切除的直肠癌患者术前行超声内镜检查,术前分期与术后病理对照,以评价EUS对直肠癌术前分期的准确性;对20例直肠癌术后保肛患者进行2年的严密随访。对术后患者随访内容:EUS、肠镜、盆腔CT、大便潜血实验和CEA监测。结果:EUS对直肠癌T分期诊断总的准确率为83.9%,周围淋巴结转移诊断的敏感性和特异性分别为57.5%和64.3%;术后随访5例患者发现局部复发,EUS检查结果均支持复发诊断。结论:EUS术前评价直肠癌临床分期具有一定的优越性,尤其对直肠癌侵犯深度的判断有较高的准确率;对直肠癌术后局部复发的早期发现EUS是一个十分有价值的检查手段。
Objective: To investigate the value of endoscopic ultrasonography (EUS) in preoperative TNM staging and postoperative local recurrence. Methods: 112 cases of resected rectal cancer patients underwent preoperative ultrasound endoscopy, preoperative staging and postoperative pathology to evaluate the accuracy of EUS preoperative staging of rectal cancer; for 20 cases of rectal cancer anal sphincter preserving Patients were followed up for 2 years. Postoperative patients were followed up: EUS, colonoscopy, pelvic CT, fecal occult blood test and CEA monitoring. Results: The overall diagnostic accuracy of EUS for T staging of rectal cancer was 83.9%. The sensitivity and specificity of EUS for the diagnosis of peripheral lymph node metastasis were 57.5% and 64.3% respectively. Five patients were followed up for local recurrence and EUS findings were supported Recurrence diagnosis. Conclusion: Preoperative evaluation of rectal cancer with EUS clinical stage has some advantages, especially for the determination of invasion depth of rectal cancer have a higher accuracy; early detection of rectal cancer after local recurrence of EUS is a very valuable means of inspection .