新加坡常规临床实践中胃镜超声分期的准确性。

Tiing Leong Ang, Tay Meng Ng, Kwong Ming Fock, Eng Kiong Teo
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引用次数: 17

摘要

目的:内镜超声已成为评估胃癌T期和N期的主要方式。本研究旨在评估内镜超声在新加坡常规临床实践中TN分期的准确性。方法:在7年的时间里,77例患者(男性70%;中位年龄62.8岁)胃癌患者术前行内镜超声分期。57名患者最终接受了手术,其组织可用于组织病理学分期和比较。结果:肿瘤部位为:贲门13例;语料库:20;切迹:19;腔:25。多数为低分化(57.1%);中分化腺癌占26%,高分化腺癌占16.9%。与病理分期相比,超声内镜下T分期的总体准确率为77.2%(分期不足17.5%,分期过高5.3%)。T1(92.9%)和T3(81.8%)的分期准确率高于T2(57.1%)和T4。对于N分期,内镜超声的准确率为59.6%(分期下26.3%;14% over-staged);这明显优于计算机断层扫描(43.9%)。结论:内镜下超声对胃癌T期诊断有较好的应用价值,总体准确率为77%,对T1期病变的准确率可达93%。显微镜下肿瘤浸润可能导致分期不足,而炎症反应可能导致分期过高。N分期的准确性较低,为60%,但可以通过细针穿刺进一步提高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Accuracy of endoscopic ultrasound staging of gastric cancer in routine clinical practice in Singapore.

Objective: Endoscopic ultrasound has emerged as the leading modality to assess the T and N stage in gastric cancer. This study aimed to assess the accuracy of TN staging by endoscopic ultrasound in routine clinical practice in Singapore.

Methods: Over a period of 7 years, 77 patients (male: 70%; median age 62.8 years) with gastric cancer underwent preoperative staging with endoscopic ultrasound. Fifty-seven patients eventually underwent surgery with tissues available for histopathological staging and comparison.

Results: The tumor locations were: cardia: 13; corpus: 20; incisura: 19; antrum: 25. The majority was poorly differentiated (57.1%); 26% were moderately differentiated and 16.9% were well differentiated adenocarcinoma. Compared to pathological staging, the overall accuracy of T staging by endoscopic ultrasound was 77.2% (17.5% under-staged: 5.3% over-staged). The staging accuracy of T1 (92.9%) and T3 (81.8%) was higher than T2 (57.1%) and T4. For N staging, the accuracy of endoscopic ultrasound was 59.6% (26.3% under-staged; 14% over-staged); this was significantly superior to computer tomography (43.9%).

Conclusion: Endoscopic ultrasound is useful for the T staging of gastric cancer, with an overall accuracy rate of 77%, and up to 93% for T1 lesions. Under-staging may occur due to microscopic tumor infiltration, while over-staging may arise due to inflammatory reactions. The accuracy of N staging is lower at 60%, but could be further improved with the use of fine needle aspiration.

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