超声内镜对早期胃癌浸润深度的诊断价值及影响因素分析

doi:10.3969/j.issn.1006-7795.2018.05.009

首都医科大学学报 ›› 2018, Vol. 39 ›› Issue (5): 669-674.doi: 10.3969/j.issn.1006-7795.2018.05.009

超声内镜对早期胃癌浸润深度的诊断价值及影响因素分析

孙秀静, 张倩, 邢洁, 朱敏, 郭俊峰, 曹彬, 朱圣韬, 李鹏, 张澍田

首都医科大学附属北京友谊医院消化内科国家消化系统疾病临床医学研究中心北京市消化疾病中心首都医科大学消化病学系消化疾病癌前病变北京市重点实验室, 北京 100050

收稿日期:2018-07-31 出版日期:2018-09-21 发布日期:2018-10-20
通讯作者: 张澍田 E-mail:zhangshutian@ccmu.edu.cn
基金资助:
国家自然科学基金（81570507），国家重点研发计划（2017YFC0113600），北京市科学技术委员会（首都临床特色应用研究）（Z141107002514018），首都卫生发展科研专项（2016-1-2022）。

Value of endoscopic ultrasonography in evaluation of invasive depth in early gastric cancer and its related factors

Sun Xiujing, Zhang Qian, Xing Jie, Zhu Min, Guo Junfeng, Cao Bin, Zhu Shengtao, Li Peng, Zhang Shutian

Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, Faculty of Gastroenterology of Capital Medical University, Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases, Beijing 100050, China

Received:2018-07-31 Online:2018-09-21 Published:2018-10-20
Supported by:
This study was supported by National Natural Science Foundation of China (81570507), National Key R&D Program of China (2017YFC0113600), Beijing Municipal Science & Technology Commission (Z141107002514018), Capital Health Research and Development of Special (2016-1-2022)。

摘要/Abstract

摘要： 目的探讨超声内镜对早期胃癌浸润深度的准确价值及影响因素。方法回顾性分析2013年6月至2017年12月于首都医科大学附属北京友谊医院诊治且资料完整的146例早期胃癌患者的临床资料，包括年龄、性别、病变部位、直径、大体形态、浸润深度、分化类型，以病理学检查结果作为判断金标准，比较超声内镜与术后病理学判断肿瘤浸润深度的一致性，分析影响超声内镜判断准确性的相关因素。率的比较和单因素分析采用χ²检验，多因素分析采用Logistic回归模型。结果超声内镜对早期胃癌浸润深度判断的准确率为73.38%，病变直径与超声内镜对早期胃癌浸润深度诊断准确性相关，而病变部位、大体形态及分化类型则与诊断准确性无关。多因素分析结果表明，病变直径是影响超声内镜（endoscopic ultrasound，EUS）检查早期胃癌（early gastric cancer，EGC）浸润深度准确性的因素，随着病灶的增大，准确性降低。结论超声内镜检查对早期胃癌浸润深度的诊断具有较好的应用价值，病变最大径会影响判断的准确性。

关键词: 早期胃癌, 超声内镜, 浸润深度

Abstract: Objective To investigate the role of endoscopic ultrasound (EUS) in assessing invasive depth of early gastric cancer (EGC) and the related factors influencing the accuracy of EUS. Methods The clinical data of 146 patients with EGC who were admitted to Beijing Friendship Hospital from June 2013 to December 2017 were retrospectively collected, including basic information (age and gender), endoscopic lesion characteristics (tumor location, size, morphology and invasive depth) and pathological features (invasive depth and differentiated types). The results of EUS were compared with pathology findings for invasive depth, and the related factors affecting the accuracy of EUS were analyzed. The rate comparison and univariate analysis were performed with the chi-square test, and multivariate analysis was performed with the Logistic regression model. Results The overall accuracy of EUS-determined invasive depth was 73.38%. The accuracy of diagnosis was associated with the tumor size, but not with the tumor location, morphology, and differentiated types. Multivariate analysis revealed that tumor size was independent risk factor affecting the accuracy of EUS in determining the invasive depth of EGC. Conclusion EUS is useful for evaluating the depth of early gastric cancer invasion. Tumor size could cause incorrect evaluation with its increasement.

Key words: early gastric cancer, endoscopic ultrasonography, invasive depth

中图分类号:

R735.2

孙秀静, 张倩, 邢洁, 朱敏, 郭俊峰, 曹彬, 朱圣韬, 李鹏, 张澍田. 超声内镜对早期胃癌浸润深度的诊断价值及影响因素分析[J]. 首都医科大学学报, 2018, 39(5): 669-674.

Sun Xiujing, Zhang Qian, Xing Jie, Zhu Min, Guo Junfeng, Cao Bin, Zhu Shengtao, Li Peng, Zhang Shutian. Value of endoscopic ultrasonography in evaluation of invasive depth in early gastric cancer and its related factors[J]. Journal of Capital Medical University, 2018, 39(5): 669-674.

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超声内镜对早期胃癌浸润深度的诊断价值及影响因素分析

Value of endoscopic ultrasonography in evaluation of invasive depth in early gastric cancer and its related factors

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