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目的探讨胃镜超声检查(EUS)在老年食管癌患者手术治疗前对其肿瘤分期及手术可切除性评估的临床价值。方法选取2010年1月至2016年1月治疗的老年食管癌患者116例,将患者术前EUS检查结果与手术及病理结果进行比较分析。结果 116例患者中EUS术前判断110例可根治性切除,其中5例术中未能切除病灶;EUS术前判断6例不能根治性切除,其中发现主动脉受侵3例,气管支气管受侵2例,这6例中,2例仍行根治术,另4例未能切除病灶。EUS判断可切除性的准确率为93.97%(109/116),灵敏度为98.13%,特异度为44.44%,阳性预测值为95.45%,阴性预测值为66.67%。EUS判断分期中,有2例T2N1MO误诊、6例T3N1MO误诊、5例T4N0MO误诊,EUS术前判断分期的准确率为88.79%(103/116)。结论 EUS评估老年食管癌手术可切除性及分期的准确性高,能够为术前制定治疗方案提供帮助。
Objective To investigate the clinical value of endoscopic ultrasonography (EUS) in evaluating the staging and surgical resectability of elderly patients with esophageal cancer before surgery. Methods A total of 116 elderly patients with esophageal cancer who were treated from January 2010 to January 2016 were selected. The preoperative EUS findings were compared with the surgical and pathological findings. Results Among the 116 patients, 110 cases were diagnosed by EUS preoperatively, of which 5 cases were not resected intraoperatively. Six cases were not able to be removed by EUS preoperatively. Among them, 3 cases were found with aortic involvement and tracheobronchial invasion 2 cases, of which 6 cases, 2 cases still radical surgery, the other 4 cases failed to remove the lesion. The accuracy of EUS in assessing resectability was 93.97% (109/116). The sensitivity was 98.13%, the specificity was 44.44%, the positive predictive value was 95.45%, and the negative predictive value was 66.67%. EUS judgment staging, 2 cases of T2N1MO misdiagnosis, 6 cases of T3N1MO misdiagnosis, 5 cases of T4N0MO misdiagnosis, EUS preoperative determination of staging accuracy rate of 88.79% (103/116). Conclusion The accuracy of EUS in evaluating the resectability and staging of elderly patients with esophageal cancer is high, which can help to make the treatment plan before operation.