超声内镜对T2期食管癌术前T分期的诊断价值及影响因素

来源 :中国胸心血管外科临床杂志 | 被引量 : 0次 | 上传用户:ajianginger
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目的探讨术前超声内镜(endoscopic ultrasonography,EUS)对T2期食管癌(esophageal carcinoma,EC)的诊断价值及影响因素。方法回顾性分析我院2015年3月至2016年1月206例EC手术患者术前EUS的检查结果和术后的病理资料,选取未经术前辅助放化疗治疗且术后病理分期为T2期的81例EC患者纳入本研究,其中男59例、女22例,平均年龄63.9岁,中位年龄63.0岁。将EUS检查T分期(c T)与术后病理T分期(p T)进行比较,采用独立样本卡方检验对纳入患者的性别,年龄,肿瘤位置,肿瘤形态,术后病理分化程度,组织学分型,淋巴结转移及术后病理TNM分期等因素进行比较,分析这些因素对T2分期诊断价值的影响。结果 EUS对病理T2期EC术前T分期准确率为61.7%,过高分期率为38.3%。EUS准确分期组与过高分期组在术后病理TNM分期上差异有统计学意义(P=0.023),术后病理TNM分期在过高T分期组较高;而性别,年龄,肿瘤位置,肿瘤形态,术后病理分化程度,组织学分型和淋巴结转移两组差异无统计学意义。结论 EUS对T2期EC术前T分期有过高的分期率,术后病理TNM分期可能是EUS对T2期EC术前过高T分期的一个影响因素。 Objective To investigate the diagnostic value and influencing factors of endoscopic ultrasonography (EUS) on T2 esophageal carcinoma (EC). Methods A retrospective analysis of our hospital from March 2015 to January 2016 206 cases of EC surgery patients preoperative EUS examination results and postoperative pathological data were selected without preoperative adjuvant radiotherapy and chemotherapy and postoperative pathological stage T2 81 cases of EC patients were included in this study, including 59 males and 22 females, with an average age of 63.9 years and a median age of 63.0 years. EUS T-staging (c T) and postoperative pathological T staging (p T) were compared, and independent sample chi-square test was used to analyze the gender, age, tumor location, tumor morphology, postoperative pathological differentiation, histological score Type, lymph node metastasis and postoperative pathological TNM staging and other factors were compared to analyze the impact of these factors on T2 staging diagnostic value. Results The accuracy of EUS in preoperative T staging was 61.7% and the overly staging rate was 38.3%. There were significant differences in pathologic TNM staging between the EUS accurate staging group and the over-staging group (P = 0.023), postoperative pathological TNM staging was higher in the over-T staging group, while gender, age, tumor location, tumor Morphology, postoperative pathological differentiation, histological type and lymph node metastasis showed no significant difference between the two groups. Conclusions EUS has an overly high staging rate for preoperative T stage of T2EC. Postoperative pathological TNM stage may be an influencing factor of EUS on T2 stage T preoperatively.
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