• 1.四川大學華西臨床醫(yī)學院/華西醫(yī)院（成都 610041）;;
  • 2.四川大學華西醫(yī)院肛腸外科（成都 610041）;;
  • 3.四川大學華西醫(yī)院放射科（成都 610041）;;
  • 4.四川大學華西醫(yī)院超聲科（成都 610041）;

目的 　比較多層螺旋CT（MSCT）和經直腸超聲（TRUS）對直腸癌患者術前分期的診斷價值。
方法 　前瞻性納入2009年1~5月期間在四川大學華西醫(yī)院肛腸外科住院的直腸癌患者，術前使用MSCT和TRUS進行T分期和N分期，并與術后病理分期進行比較。
結果 　本研究納入患者81例。在評估局部浸潤方面，MSCT的準確度為77.78%(63/81)，TRUS為88.89%(72/81)，差異無統(tǒng)計學意義（P=0.168）。在診斷轉移性淋巴結方面，MSCT的準確度為66.67%(54/81)，TRUS為48.15%(39/81)，差異有統(tǒng)計學意義（P=0.034）。
結論 　TRUS在評估直腸癌局部浸潤深度上更為準確，但與MSCT之間的差異并不明顯。MSCT在診斷直腸癌淋巴結轉移方面比TRUS更具優(yōu)越性，但兩者的準確性都還有待進一步提高

引用本文： 陳曉婧 ,蘭凱,汪曉東,呂東昊,余敏,李崢艷,時瑩瑜,李立. 多層螺旋CT和經直腸超聲在直腸癌術前分期中的價值. 中國普外基礎與臨床雜志, 2009, 16(9): 702-705. doi: 復制

1. 汪曉東, 呂東昊, 曾天芳, 等. 多學科協(xié)作診治模式下結直腸癌術前輔助檢查系統(tǒng)的臨床應用初步探索 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(1): 7074.
2. 汪曉東, 何帆, 鄧窈窕, 等. 直腸癌術前經直腸超聲評估保肛或非保肛手術方案的臨床前瞻性研究 [Ｊ]. 臨床外科雜志, 2008; 16(11): 755757.
3. Engelen SM, Beets GL, BeetsTan RG. Role of preoperative local and distant staging in rectal cancer [Ｊ]. Onkologie, 2007; 30(3): 141145.
4. Theoni RF. Colorectal cancer: crosssectional imaging for staging of primary tumor and detection of local recurrence [Ｊ]. AJR Am J Roentgenol, 1991; 156(5): 909915.
5. Hildebrandt U, Feifel G. Preoperative staging of rectal cancer by intrarectal ultrasound [Ｊ]. Dis Colon Rectum, 1985; 28(1): 4246.
6. Greene FL, Page DL, Fleming ID, et al Eds. AJCC cancer staging manual [M]. 6th ed. New York (NY): Springer Verlag, 2002: 113124.
7. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncologyrectal cancer, v.4.2008, http: //www.nccn.org/professionals/physician_gls/PDF/rectal.pdf.
8. 汪曉東, 呂東昊, 崔貝貝, 等. 術前經直腸超聲評估直腸癌手術方案的隨機對照試驗 [Ｊ]. 中國循證醫(yī)學雜志, 2008; 8(12): 10431046.
9. Kwok H, Bissett IP, Hill GL. Preoperative staging of rectal cancer [Ｊ]. Int J Colorectal Dis, 2000; 15(1): 920.
10. Rifkin MD, Ehrlich SM, Marks G. Staging of rectal carcinoma: prospective comparison of endorectal US and CT [Ｊ]. Radiology, 1989; 170(2): 319322.
11. Hünerbein M. Endorectal ultrasound in rectal cancer [Ｊ]. Colorectal Dis, 2003; 5(5): 402405.
12. Dinter DJ, Hofheinz RD, Hartel M, et al. Preoperative staging of rectal tumors: comparison of endorectal ultrasound, hydroCT, and highresolution endorectal MRI [Ｊ]. Onkologie, 2008; 31(5): 230235.
13. Panzironi G, De Vargas Macciucca M, Manganaro L, et al. Preoperative locoregional staging of rectal carcinoma: comparison of MR, TRUS and Multislice CT. Personal experience [Ｊ]. Radiol Med, 2004; 107(4): 344355.
14. Matsuoka H, Nakamura A, Masaki T, et al. Preoperative staging by multidetectorrow computed tomography in patients with rectal carcinoma [Ｊ]. Am J Surg, 2002; 184(2): 131135.
15. Bipat S, Glas AS, Slors FJ, et al. Rectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT and MR imaging-a metaanalysis [Ｊ]. Radiology, 2004; 232(3): 773783.
16. Kim JC, Kim HC, Yu CS, et al. Efficacy of 3dimensional endorectal ultrasonography compared with conventional ultrasonography and computed tomography in preoperative rectal cancer staging [Ｊ]. Am J Surg, 2006; 192(1): 8997.
17. Birnbaum EH. What’s new in colon and rectal surgery [Ｊ]. J Am Coll Surg, 2006; 202(3): 485494.
18. Goertz RS, Fein M, Sailer M. Impact of biopsy on the accuracy of endorectal ultrasound staging of rectal tumors [Ｊ]. Dis Colon Rectum, 2008; 51(7): 11251129.
19. Karantanas AH, Yarmenitis S, Papanikolaou N, et al. Preoperative imaging staging of rectal cancer [Ｊ]. Dig Dis, 2007; 25(1): 2032.
20. Dworak O. Number and size of lymph nodes and node metastases in rectal carcinomas [Ｊ]. Surg Endosc, 1989; 3(2): 9699.
21. Mnig SP, Baldus SE, Zirbes TK, et al. Lymph node size and metastatic infiltration in colon cancer [Ｊ]. Ann Surg Oncol, 1999; 6(6): 579581.
22. Gollub MJ, Schwartz LH, Akhurst T. Update on colorectal cancer imaging [Ｊ]. Radiol Clin North Am, 2007; 45(1): 85118.
23. 汪曉東, 宋歡, 呂東昊, 等. 術前聯(lián)合評估直腸上段癌與手術方案選擇的隨機對照試驗 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(4): 322326.
24. 汪曉東, 尹源, 陸玫竹, 等. 經直腸超聲聯(lián)合血清淀粉樣蛋白A術前評估中低位直腸癌與手術決策的隨機對照試驗 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(5): 407412.
  1. 1. 汪曉東, 呂東昊, 曾天芳, 等. 多學科協(xié)作診治模式下結直腸癌術前輔助檢查系統(tǒng)的臨床應用初步探索 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(1): 7074.
  2. 2. 汪曉東, 何帆, 鄧窈窕, 等. 直腸癌術前經直腸超聲評估保肛或非保肛手術方案的臨床前瞻性研究 [Ｊ]. 臨床外科雜志, 2008; 16(11): 755757.
  3. 3. Engelen SM, Beets GL, BeetsTan RG. Role of preoperative local and distant staging in rectal cancer [Ｊ]. Onkologie, 2007; 30(3): 141145.
  4. 4. Theoni RF. Colorectal cancer: crosssectional imaging for staging of primary tumor and detection of local recurrence [Ｊ]. AJR Am J Roentgenol, 1991; 156(5): 909915.
  5. 5. Hildebrandt U, Feifel G. Preoperative staging of rectal cancer by intrarectal ultrasound [Ｊ]. Dis Colon Rectum, 1985; 28(1): 4246.
  6. 6. Greene FL, Page DL, Fleming ID, et al Eds. AJCC cancer staging manual [M]. 6th ed. New York (NY): Springer Verlag, 2002: 113124.
  7. 7. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncologyrectal cancer, v.4.2008, http: //www.nccn.org/professionals/physician_gls/PDF/rectal.pdf.
  8. 8. 汪曉東, 呂東昊, 崔貝貝, 等. 術前經直腸超聲評估直腸癌手術方案的隨機對照試驗 [Ｊ]. 中國循證醫(yī)學雜志, 2008; 8(12): 10431046.
  9. 9. Kwok H, Bissett IP, Hill GL. Preoperative staging of rectal cancer [Ｊ]. Int J Colorectal Dis, 2000; 15(1): 920.
  10. 10. Rifkin MD, Ehrlich SM, Marks G. Staging of rectal carcinoma: prospective comparison of endorectal US and CT [Ｊ]. Radiology, 1989; 170(2): 319322.
  11. 11. Hünerbein M. Endorectal ultrasound in rectal cancer [Ｊ]. Colorectal Dis, 2003; 5(5): 402405.
  12. 12. Dinter DJ, Hofheinz RD, Hartel M, et al. Preoperative staging of rectal tumors: comparison of endorectal ultrasound, hydroCT, and highresolution endorectal MRI [Ｊ]. Onkologie, 2008; 31(5): 230235.
  13. 13. Panzironi G, De Vargas Macciucca M, Manganaro L, et al. Preoperative locoregional staging of rectal carcinoma: comparison of MR, TRUS and Multislice CT. Personal experience [Ｊ]. Radiol Med, 2004; 107(4): 344355.
  14. 14. Matsuoka H, Nakamura A, Masaki T, et al. Preoperative staging by multidetectorrow computed tomography in patients with rectal carcinoma [Ｊ]. Am J Surg, 2002; 184(2): 131135.
  15. 15. Bipat S, Glas AS, Slors FJ, et al. Rectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT and MR imaging-a metaanalysis [Ｊ]. Radiology, 2004; 232(3): 773783.
  16. 16. Kim JC, Kim HC, Yu CS, et al. Efficacy of 3dimensional endorectal ultrasonography compared with conventional ultrasonography and computed tomography in preoperative rectal cancer staging [Ｊ]. Am J Surg, 2006; 192(1): 8997.
  17. 17. Birnbaum EH. What’s new in colon and rectal surgery [Ｊ]. J Am Coll Surg, 2006; 202(3): 485494.
  18. 18. Goertz RS, Fein M, Sailer M. Impact of biopsy on the accuracy of endorectal ultrasound staging of rectal tumors [Ｊ]. Dis Colon Rectum, 2008; 51(7): 11251129.
  19. 19. Karantanas AH, Yarmenitis S, Papanikolaou N, et al. Preoperative imaging staging of rectal cancer [Ｊ]. Dig Dis, 2007; 25(1): 2032.
  20. 20. Dworak O. Number and size of lymph nodes and node metastases in rectal carcinomas [Ｊ]. Surg Endosc, 1989; 3(2): 9699.
  21. 21. Mnig SP, Baldus SE, Zirbes TK, et al. Lymph node size and metastatic infiltration in colon cancer [Ｊ]. Ann Surg Oncol, 1999; 6(6): 579581.
  22. 22. Gollub MJ, Schwartz LH, Akhurst T. Update on colorectal cancer imaging [Ｊ]. Radiol Clin North Am, 2007; 45(1): 85118.
  23. 23. 汪曉東, 宋歡, 呂東昊, 等. 術前聯(lián)合評估直腸上段癌與手術方案選擇的隨機對照試驗 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(4): 322326.
  24. 24. 汪曉東, 尹源, 陸玫竹, 等. 經直腸超聲聯(lián)合血清淀粉樣蛋白A術前評估中低位直腸癌與手術決策的隨機對照試驗 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(5): 407412.