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| Diagnostic value of preoperative T staging of rectal cancer patients by alone and combined using intracavitary probes transrectal ultrasonography |
| YANG Pu-xu, WANG Xue-mei, BIAN Dong-lin, HUANG Kun |
| Department of Ultrasonography, the First Hospital of China Medical University, Shenyang 110001, China |
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Abstract Objective: To investigate the efficiency of combined using head scanning and 360° intracavitary probe transrectal ultrasonography(TRUS) in the diagnosis of T staging in rectal cancer patients. Methods: Sixty-six patients were from the department of ultrasound of our hospita from January 2016 to April 2017, who were all rectal cancer patients proved by pathology after surgery. Using Hitachi Pre ultrasonic diagnostic instrument, probe using head scanning intracavitary probe(4～8 MHz) and ring array 360° probe(5～10 MHz), two kinds of probes were used in transrectal ultrasound examination of the 66 cases of rectal cancer patients before surgery. After the probe was inserted into the patient’s anus, by moving and rotating probe method the levels of the tumor infiltrating the intestinal wall, and the postoperative pathological T staging of the patients was obtained by the HIS system, use higher staging when the stages were inconsistent. The accuracy of ultrasonic uT staging with the results of postoperative pathological T staging was compared. For the comparison of the diagnostic efficiency of ultrasonic staging and pathological T staging, the Kappa analysis method was used for consistency analysis of single and combined using two kinds of probes. The greater the Kappa value, the higher the diagnostic consistency was. Chi square analysis was used to compare the diagnostic effectiveness of the two probes respectively, P<0.05 has statistical significance. Results: Sixty-six cases of rectal cancer patients were included in this study, using head scanning intracavitary probe T staging. Eleven patients were overstage and 7 patients were lack of staging, accuracy rate was 72.7%(k=0.625). Using 360° intracavitary probe T staging 6 patients were overstage and 9 patients were lack of staging, accuracy rate was 77.2%(k=0.690). Combined using the two probe T staging, 4 patients were overstage and 3 patients were lack of staging, accuracy rate was 89.3%(k=0.855). Compared with head scanning probe and two kinds of probe combined result was χ2=7.697 and P=0.020, compared with 360° probe and two kinds of probe combined result was χ2=7.701 and P=0.006. And the Kappa value with combined using two kinds of probe T staging compared with pathological results was significantly higher than that of the Kappa value head scanning intracavitary probe and 360° intracavitary probe were used alone compared with T staging and pathological, and the accuracy rate of T staging compared with pathological T staging using head scanning and 360° intracavitary probe was statistically significant different with the accuracy rate of the T staging of combined using the two kinds of probe. Conclusion: The combined using of head scan and 360° intracavitary probe can improve the accuracy of preoperative T staging for rectal cancer patients, which is helpful for assisting doctors to develop reasonable treatment plan and improve the accuracy of preoperative T staging of rectal cancer.
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Received: 11 July 2018
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