The Study Of Endorectal Ultrasonography In Evaluating Accuracy Of Rectal Cancer Of Preoperative Tn Staging And Anal Sphincter Defect

Objective：To evaluate the accuracy of endorectal ultrasonography (ERUS) inrectal cancer of preoperative TN staging and in anal sphincter defect.Methods：One hundred and twenty five patients (73males，52females) in JilinUniversity First Hospital Department two from October2012to April2015withrectal cancer underwent endorectal ultrasonography evaluation，with a mean age of61.2(ranging between35and85).One hundred and twenty five patients with rectalcancer confirmed by pathology were chosen to perform ERUS before surgery topredict TN staging．ERUS preoperative staging result and postoperative pathologicstage did comparative study．The result of the postoperative pathologic consistencytest analysis by using SPSS17.0．The second part of this study collected6casespatients (female，a mean age of44) who magnified anal incontinence in the sameperiod．We could record defect’s location and range，storing image at the same timeby observing anal hierarchy and structure， Whether anal sphincter existedfragmentation and damage．Compared with surgical results，ERUS recognized analsphincter defect accurately．Results：The accuracy of ERUS for assessing local depth of invasion of rectalcarcinoma(T stage) was83.6%(105out of125)，overstaging in14patients，understaging in6patients．The diagnostic accuracy rates in uT1～uT4stage byERUS were99.2%，89.6%，84.8%and94.4%．The ultrasound T-staging was highlyconsistent with the pathological T-staging(Kappa=0.761，p=0.000)．Lymph nodesmetastasis were found in44cases，Lymph node were not found in81cases．Therewas99patients consistent with two results．ERUS was correctly predicted lymphnode metastases in38patients and no lymph node metastases in87patients．Theaccuracy rate of ERUS in N-staging of rectal cancer was79.2%．The sensitivity rate of ERUS in N-staging of rectal cancer was63.6%，while the specificity rate ofERUS in N-staging of rectal cancer was87.7%.The positive predictive value andnegative predictive value was found to be73.7%and81.6%respectively．Theultrasound N-staging was not satisfied enough consistent with the pathologicalN-staging(Kappa=0.529，p=0.000)．Six patients with fecal incontinence underwent ERUS．Internal anal sphincterand external anal sphincter had defection partly with different locations andangle．ERUS could clearly show the location of the sphincter defect and scope，thefollow-up consistent with intra operation．Conclusions：1、ERUS is highly consistent with the pathological T staging and canaccurately assess the depth of invasion of rectal cancer．It may provide reliableevidence for clinical preoperative stage．2、ERUS preoperative of N-staging result sometimes is not satisfied enoughand combination other imaging technology may be needed for comprehensiveevaluation．3、ERUS applies anal sphincter defect into recording angel and scale，contributing to offer diagnosis and cause of a disease．4、ERUS can be used as the first choice for the diagnosis of anorectaldiseases.