胃肠超声造影联合超声内镜对老年胃癌患者T分期的价值研究

Clinical value of gastrointestinal ultrasonography combined with echoendoscope for T staging of gastric cancer in the elderly patients

摘要:

目的 探讨胃肠超声造影联合超声内镜在老年胃癌患者T分期中的应用价值。方法 回顾性分析2016年1月－2021年12月在该院诊疗的102例老年胃癌患者的临床资料，年龄60～78岁，术前1周均行胃肠超声造影和超声内镜。观察不同检查方法术前的影像学诊断资料，以术后病理T分期作为诊断金标准，比较胃肠超声造影、超声内镜和胃肠超声造影联合超声内镜在老年胃癌患者T分期中的临床应用价值。结果 胃肠超声造影对老年胃癌患者T分期总体诊断准确率为70.59%，超声内镜总体诊断准确率为73.53%，胃肠超声造影联合超声内镜总体诊断准确率为85.29%。胃肠超声造影联合超声内镜在老年胃癌患者T分期中，总体诊断准确率明显高于单独胃肠超声造影和超声内镜（P < 0.05）；对于T₁期和T₂期老年胃癌患者，联合检查诊断准确率略高于超声内镜，高于胃肠超声造影，但差异均无统计学意义（P > 0.05）；对于T₃期老年胃癌患者，胃肠超声造影与超声内镜诊断准确率相当，略低于联合检查，差异均无统计学意义（P > 0.05）；对于T₄期老年胃癌患者，联合检查诊断准确率略高于胃肠超声造影（P > 0.05），而明显高于超声内镜（P < 0.05）。结论 胃肠超声造影联合超声内镜，能明显提高老年胃癌患者T分期总体诊断准确率；对于T₁期和T₂期老年胃癌患者，可优先选择超声内镜；对于T₃期和T₄期老年胃癌患者，可选择联合检查，以弥补单一检查的不足，从而为临床手术方案的选择，提供更精确的指导。

Abstract:

Objective To explore the application value of gastrointestinal ultrasonography combined with echoendoscope in the T stage of gastric cancer in the elderly patients.Methods A retrospective analysis was conducted on the clinical data of 102 elderly gastric cancer patients aged 60~78 years old from January 2016 to December 2021, and gastrointestinal ultrasonography and echoendoscope were examined one week before surgery. The clinical values of gastrointestinal ultrasonography, echoendoscope, gastrointestinal ultrasonography combined with echoendoscope in T stage of elderly patients were compared by observing the preoperative imaging diagnostic data of different examination methods, and taking postoperative pathological T staging as the gold standard for diagnosis.Results The overall diagnostic accuracy of gastrointestinal ultrasonography for T stage of elderly gastric cancer was 70.59%, the accuracy of echoendoscope diagnosis was 73.53%, and the diagnostic accuracy of gastrointestinal ultrasonography combined with echoendoscope was 85.29%. In the T stage of elderly gastric cancer, the diagnostic accuracy of gastrointestinal ultrasonography combined with echoendoscope was significantly higher than that of gastrointestinal ultrasonography and echoendoscope alone. For T₁ and T₂ elderly gastric cancer, the diagnostic accuracy of combined examination was higher than that of echoendoscope and higher than that of gastrointestinal ultrasonography, but there were no significant differences (P > 0.05). For T₃ elderly gastric cancer, gastrointestinal ultrasonography had the same diagnostic accuracy as echoendoscope, but was lower than that of combined examination, but there were no significant differences (P > 0.05). For T₄ elderly gastric cancer, the diagnostic accuracy of combined examination was higher than that of gastrointestinal ultrasonography, but there was no significant difference (P > 0.05), and significantly higher than that of echoendoscope (P < 0.05).Conclusion Gastrointestinal ultrasonography combined with echoendoscope significantly improve the overall diagnostic accuracy of T stage of gastric cancer in the elderly. For stage T₁ and T₂ elderly gastric cancer, echoendoscope can be selected; For T₃ and T₄ gastric cancer, combined examination can be selected to make up for the shortcomings of single examination and provide more accurate guidance for the selection of clinical surgical plan.