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目的超声小探头ultrasonicminiprobeUMP应用于结、直肠癌术前分期的准确性及可行性。方法对50例结、直肠癌患者做UMP检查,对准病灶进行全瘤扫描,择最佳影像冻结、摄片。退出UMP,最后做活组织检查。全部病例均行根治术,癌周淋巴结分组编号、装瓶,送病理检查。结果本组UMP对50例结、直肠浸润深度(T分期)与术后病理浸润深度对比,其准确率T1～T4期分别为75%,80%,88%及67%,T分期的总准确率为84%(P<0.01),过高分期5例(10%),过低分期3例(6%);N分期:UMP诊断阳性淋巴结(n=22),术后病理(n=28),准确率79%,UMP诊断阴性淋巴结(n=20),术后病理(n=22),准确率91%。总准确率84%(42/50),敏感性79%,特异性为91%(P<0.01)。结论(1)UMP是当前应用于结、直肠癌术前TNM分期最有实用价值的方法之一,肿瘤狭窄患者适应术前分期检查。(2)UMP系高频超声探头,由于超声穿透深度的限制,对远处转移的M分期是不可能的。(3)UMP对浸润深度及近处淋巴结转移有一定参考价值,并应结合其它影像检查如腹部B超、CT等,扬长弃短、相辅相成,以提高术前分期的准确性及完整性。
Objective To evaluate the accuracy and feasibility of ultrasonic miniprobe UMP in the preoperative staging of colorectal cancer. Methods UMP examinations were performed on 50 patients with colorectal cancer. All tumors were scanned on the lesions and the best images were frozen and photographed. Exit UMP, and finally do a biopsy. All patients underwent radical surgery, lymph node grouping, numbering, bottling, and pathological examination. Results The UMP of this group compared the depth of invasive depth of the rectum (T staging) with postoperative pathological depth in 50 cases. The accuracy rate was 75%, 80%, 88%, and 67% in the T1 to T4 phases, respectively. The rate was 84% (P<0.01), oversizing was in 5 cases (10%), 3 cases were in low-grade (6%); N-stage: UMP diagnosed in positive lymph nodes (n=22), postoperative pathology (n=28 The accuracy rate was 79%. UMP diagnosed negative lymph nodes (n=20) and postoperative pathology (n=22). The accuracy rate was 91%. The overall accuracy was 84% (42/50), sensitivity was 79%, and specificity was 91% (P<0.01). Conclusions (1) UMP is one of the most practical methods currently applied to the preoperative TNM staging of colorectal cancer. Tumor stenosis patients are adapted to the preoperative staging examination. (2) UMP-based high-frequency ultrasound probes, due to the limitations of ultrasound penetration depth, M staging for distant metastasis is not possible. (3) UMP has a certain reference value for infiltration depth and proximal lymph node metastasis, and should be combined with other imaging examinations such as abdominal ultrasound, CT, etc., lengthening and shortening, complement each other to improve the accuracy and integrity of preoperative staging.