比较三维内直肠超声波和放大色素内镜用于早期直肠瘤侵袭深度评估
Rodrigo Ambar Pinto1, Fábio Shiguehissa Kawaguti2, Cintia Mayumi Sakurai Kimura1,3
1Division of Colon and Rectal Surgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Journal of gastroenterology and hepatology
|November 6, 2023
概括
放大色素内镜 (MCE) 在评估直肠瘤侵袭深度方面,比三维内肠直肠超声波 (3D-ERUS) 更高的准确性. 这两种方法都对治疗规划有价值.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 医疗成像医学成像
背景情况:
- 准确评估直肠瘤侵袭深度对于有效的治疗选择至关重要.
- 早期的直肠癌需要精确的分期,以确定是否需要进行局部切除和激进手术.
研究的目的:
- 为了比较三维内肠直肠超声波 (3D-ERUS) 和放大染色内肠镜 (MCE) 的诊断准确度,评估直肠瘤的头顶侵袭深度 (T阶段).
- 在指导治疗决策时评估两种成像模式的性能.
主要方法:
- 一项前性研究,包括70名患有中间和远端直肠瘤的患者.
- 两个独立提供商使用3D-ERUS和MCE对T阶段的盲目评估.
- 将成像结果与手术样本组织病理学结果进行比较,计算灵敏度,特异性,精度,PPV和NPV.
主要成果:
- 与3D-ERUS (85.7%) 相比,MCE获得了更高的精度 (94.3%).
- MCE显示了更高的特异性 (96.4%) 和PPV (86.7%),而3D-ERUS具有更高的灵敏度 (93.3%) 和NPV (97.9%).
- 卡帕值表明两种方法的良好一致性,MCE (0.83) 的表现优于3D-ERUS (0.64).
结论:
- 无论是MCE还是3D-ERUS,都为评估直肠瘤入侵提供了良好的诊断性能.
- 与3D-ERUS.com相比,MCE在分期直肠瘤入侵深度方面表现出更高的准确性.
- 这两种内镜技术都可靠地评估了病变延伸,周围卷入和从门边缘的距离.
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