微探头超声内镜诊断对可切除性食管癌患者的临床应用价值

Analysis of clinical application value of micro probe endoscopic ultrasonography in patients with resectable esophageal cancer

摘要:

目的 探究微探头超声内镜（MPS）诊断对可切除性食管癌患者的临床应用价值。方法 选取2017年1月－2020年1月在该院进行治疗的70例食管癌患者，所有患者均行磁共振扩散加权成像（DWI）与MPS检测。根据检查方式差异分为DWI组和MPS组，最终诊断结果由手术标本活检得出。比较DWI组和MPS组患者食管癌病变长度、T分期检查结果和诊断价值的差异性。结果 DWI组患者检查出食管癌病变长度为（47.45±9.34）mm，与最终结果相比较，DWI组患者食管癌病变长度检出明显较长，数值相差较大（P < 0.05），MPS组患者检查出食管癌病变长度为（42.56±8.56）mm，与最终结果相比较，MPS组患者食管癌病变长度检出数值相差较小（P > 0.05）。MPS组检查出T₁、T₂、T₃和T₄期患者分别为21、35、9和5例，DWI组检查出T₁、T₂、T₃和T₄期患者分别为25、31、12和2例，MPS组与DWI组比较，差异无统计学意义（P > 0.05）。DWI组检测灵敏度、特异度和准确率分别为86.73%、72.45%和83.65%，MPS组诊断价值分别为87.34%、89.03%和97.34%，DWI组和MPS组比较，MPS组诊断特异度和准确率明显较高（P < 0.05），但灵敏度相差较小（P > 0.05）。DWI检测食管癌患者受试者工作特征曲线（ROC）下面积（AUC）为0.748，MPS检测食管癌患者AUC为0.803，MPS检测食管癌诊断价值更高。结论 DWI与MPS相比较，后者对可切除性食管癌患者的诊断效果更佳，能够更准确地判断患者食管病变长度。

Abstract:

Objective To explore the clinical application value of micro probe endoscopic ultrasonography (MPS) in the diagnosis of resectable esophageal cancer.Methods We selected 70 patients with esophageal cancer from January 2017 to January 2020 as research subjects. All the patients underwent magnetic resonance diffusion weighted imaging and MPS. According to the examination method difference, they were divided into the magnetic resonance diffusion weighted imaging group (DWI group) and MPS group. The final diagnosis result is obtained by biopsy of the surgical specimen.Results The length of the esophageal cancer lesions in the DWI group was (47.45 ± 9.34) mm. Compared with the final result, the lengths of the esophageal cancer lesions in the DWI group were significantly longer, and the values were significantly different (P < 0.05). The length of the esophageal cancer lesion was (42.56 ± 8.56) mm. Compared with the final result, the length of the esophageal cancer lesion detected in the MPS group was slightly different (P > 0.05). There were 21 cases, 35 cases, 9 cases and 5 cases were diagnosed with T₁, T₂, T₃ and T₄ stage respectively in MPS group, and 25 cases, 31 cases, 12 cases and 2 cases were diagnosed with T₁, T₂, T₃ and T₄ stage respectively in DWI group. There was no significant difference between MPS group and DWI group (P > 0.05). The detection sensitivity, specificity, and accuracy of the DWI group were 86.73%, 72.45%, and 83.65%, respectively. The diagnostic value of the MPS group was 87.34%, 89.03%, and 97.34%. Compared with the DWI group, the diagnostic specificity and the accuracy of the MPS group were significantly higher (P < 0.05), but the difference in sensitivity between the two groups was small (P >0.05). The AUC value of patients with esophageal cancer detected by DWI was 0.748, the AUC value of patients with esophageal cancer detected by MPS was 0.803, and the diagnostic value of MPS for esophageal cancer was higher.Conclusion Compared with DWI, the MPS has a better diagnostic effect for patients with resectable esophageal cancer, and can more accurately determine the length of esophageal lesions.