Efficacy Of Endoscopic Ultrasonography In Preoperative TN Staging Of Rectal Cancer

Objective: To evaluate the efficacy of endoscopic ultrasonography in preoperative TN staging of rectal cncer.Methods: Collected 74 patients with rectal cancer radical resection and preoperative ultrasound endoscopic TN staging from Endoscopy Center from June 2014 to October 2016.All the ultrasound images were collected by experienced endoscopic physician Staging.Consistence comparison of EUS preoperative staging and pathological staging was performed to identify the value of EUS preoperative staging.Result: This study included 74 patients,42 males accounting for 56.8% and 32 females accounting for 43.2%.These patients' average age was 55±19 year-s old.The number of patients diagnosed by endoscopic ultrasonography as T1,T2,T3,T4 was 15,28,21,10.But ensured by postoperative pathology,there were 15 patients diagnosed as T1 phase,2 patients overstaging.There were 29 patients diagnosed as T2 phase,2 patient understaging and 43 patients overstaging.There were 19 patients diagnosed as T3 phase,2patients overstaging and 4 patients understaging.The last 11 patients were diagnosed as T4 phase,1 patients understaging.The overall concordance rates of EUS in T st-aging was 81.1%.The accuracy,sensitivity and specificity of T staging were 86.7%,86.7%,96.6% for T1 tumors,79.3%,79.3%,88.9% for T2 tumors,78.9%,78.9%,89.0% for T3 tumors,81.8%,81.8%,98.4% for T4 tumors.25 cases of pathologically proven lymph node metastasis;Endoscopic ultrasonography results of 29 c-ases of suspicious lymph node metastasis,and postoperative pathologic result-comparison shows the false positives(15);Endoscopic ultrasonography results considering no lymph node metastasis 45 cases,61 cases final results confirm t-o the lymph node positive.The accuracy,sensitivity and specificity of N stagi-ng were 64.9%,56.0%,69.4%.Kappa method was used to evaluate the consistency of EUS staging and pathological findings.The K value of T staging was 0.736(0.4?K?0.75,P<0.001),and the N value was 0.244(K<0.4,P>0.001).Conclusion: 1.The endoscopic ultrasonography provides good predictive data for T staging of rectal cancer,2.For the determination of lymph node metastasis is accurate,but the sensitivity to be improved.3.The endoscopic ultrasonography for rectal cancer TN staging accuracy,T stage is better than N staging.