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目的 :探讨内镜超声检查 (EUS)对胃癌淋巴结状况术前评估的价值。方法 :对 12 4例经胃镜活检证实的胃癌病人术前行内镜超声检查 ,并与手术病理对照。结果 :EUS对胃癌淋巴结状况的判断准确度、淋巴结转移的敏感度和特异度分别为 82 .1%、76 .3%和 89.4 %。EUS对胃癌N分期的准确度 6 5 .1% ,其中N0 89.4 %、N1 6 4 .3%、N2 2 9.0 % ,且其对T1 T2 和T3 T4 期胃癌N分期的准确度分别为 82 .4 %和 4 9.1% ,具有统计学意义 (χ2 =10 .0 8,P <0 .0 0 1)。EUS对胃周转移淋巴结的检出率为 2 6 .4 % ,且转移淋巴结直径越大 ,其检出率也越高。同时 ,EUS对各组淋巴结转移的敏感度为37.8% ,其中对第 3组的敏感度达 71.1% ,与总体敏感度相比具统计学意义 (χ2 =16 .6 7,P <0 .0 0 1)。结论 :内镜超声检查对胃癌术前评估淋巴结状况具较高的临床应用价值。
Objective: To investigate the value of endoscopic ultrasonography (EUS) in the preoperative evaluation of lymph node status of gastric cancer. Methods: 12 4 cases of gastric cancer confirmed by gastroscopy biopsy before endoscopic ultrasonography and surgical pathology control. Results: The diagnostic accuracy of lymph node status and the sensitivity and specificity of EUS for gastric cancer were 82.1%, 76.3% and 89.4%, respectively. The accuracy of EUS in staging of gastric cancer was 65.1%, of which N0 89.4%, N1 64.3% and N2 2 9.0%. The accuracy of EUS staging for gastric cancer was 82% for T1 staging and T3 T4 staging respectively. 4% and 4 9.1%, respectively, with statistical significance (χ2 = 10.08, P <0.001). The detection rate of EUS on the peritumoral lymph nodes was 26.4%, and the larger the diameter of metastatic lymph nodes, the higher the detection rate was. At the same time, the sensitivity of EUS to lymph node metastasis in each group was 37.8%, of which the sensitivity to group 3 was 71.1%, which was statistically significant compared with the overall sensitivity (χ2 = 16.67, P <0. 0 0 1). Conclusion: Endoscopic ultrasonography has a high clinical value in assessing lymph node status before surgery.