超声内镜实时组织弹性成像对食管癌淋巴结转移的诊断价值研究

Diagnostic value of endoscopic ultrasound elastography in lymph node metastasis of esophagus cancer

摘要:

摘要：目的 探讨超声内镜（EUS）实时组织弹性成像技术对食管癌淋巴结转移术前诊断的准确性。方法 2014年9月－2017年8月收治经病理证实的食管癌患者31例，共对115个淋巴结进行EUS及EUS实时组织弹性成像检查，后行食管癌根治术及淋巴结清扫术，对所有的淋巴结进行病理确诊。运用χ2检验比较两种方法诊断食管癌淋巴结转移的灵敏度、特异度和准确度。结果 31例入组患者病理诊断均为食管鳞状细胞癌。115个目标淋巴结中，经切除及病理诊断确诊：非转移淋巴结91个，淋巴结转移24个；实时弹性成像结果显示：非转移淋巴结86个，转移淋巴结22个。其灵敏度、特异度及准确度分别为91.7%、94.5%和93.9%。EUS显示转移淋巴结15个，非转移淋巴结67个，其灵敏度、特异度及准确度分别为62.5%、73.6%和71.3%。经χ2检验，实时超声弹性成像的灵敏度、特异度及准确度均高于EUS，差异有统计学意义（P <0.05）。结论 EUS实时组织弹性成像对食管癌淋巴结转移术前诊断的灵敏度、特异度和准确度均明显高于EUS，值得临床进一步推广应用。

Abstract:

Abstract: Objective To evaluate the accuracy of endoscopic ultrasound elastography in the diagnosis of lymph node metastasis of esophageal carcinoma. Methods From September 2014 to August 2017, 31 esophageal cancer patients with 115 lymph nodes were detected by EUS and endoscopic ultrasound elastography, followed by esophageal cancer radical surgery and lymphadenectomy. All of the lymph nodes were confirmed by pathology. The sensitivity, specificity and accuracy of the two methods in the diagnosis of lymph node metastasis of esophageal carcinoma were compared by χ2 test. Results 31 patients were diagnosed as esophageal squamous cell carcinoma. Of the 115 target lymph nodes, 91 were non-lymph node metastases and 24 were metastatic lymph nodes diagnosed by resection and pathology. Endoscopic ultrasound elastography results showed 86 cases were non-metastatic lymph nodes and 22 cases were metastatic lymph nodes. The sensitivity, specificity and accuracy of endoscopic ultrasound elastography were 91.7%, 94.5% and 93.9%, respectively. EUS showed that there were 15 metastatic lymph nodes and 67 non-metastatic lymph nodes, and the sensitivity, specificity and accuracy were 62.5%, 73.6% and 71.3%, respectively. Conclusion The sensitivity, specificity and accuracy of endoscopic ultrasound elastography in preoperative diagnosis of lymph node metastasis for esophageal cancer patients are significantly higher thanthat of EUS.