MRI在直肠癌术前分期中的准确性分析

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摘要目的分析MRI在直肠癌术前分期中的准确性。方法选择2012年12月~2014年4月于中山大学附属第六医院接受MRI检查并通过活检组织病理确诊的原发性直肠癌患者154例，通过对比其术后病理分期，分析MRI术前分期准确率。结果将T分期分为T3～4期及T0～2期，其准确率、灵敏度、特异度、阳性预测值和阴性预测值分别为77.9%、93.3%、46%、78.2%和76.7%。而N分期分为N+期和N0期，分别是57.1%、78.2%、45.5%、44.3%和78.9%。TNM分期分为Ⅱ~Ⅲ期和0～Ⅰ期，分别是79.9%、93.1%、39.5%、82.4%和65.2%。结论 MRI是一种准确的直肠癌术前分期方法，TN分期均具有较高的灵敏度，但是特异度不高，可能会导致过度分期。

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	林伟达骆衍新

关键词 ：直肠癌, MRI, 术前分期, 准确性

Abstract：Objective To evaluate the accuracy of preoperative MRI staging in primary rectal cancer patients. Methods From December 2012 to April 2014, in Sixth Affiliated Hospital of Sun Yat-Sen University, 154 primary rectal cancer patients underwent MRI before surgery were selected. The accuracy of preoperative MRI was analyzed by comparing with postoperative pathological stage. Results T stage was divided into T3-4 stage and T0-2 stage, the accuracy, sensitivity, specificity, PPV, NPV were 77.9%, 93.3%, 46%, 78.2%, 76.7%. N stage was divided into N+ stage and N0 stage, the accuracy, sensitivity, specificity, PPV, NPV were 57.1%, 78.2%, 45.5%, 44.3%, 78.9%. TNM stage was divided into Ⅱ-Ⅲ stage and 0-Ⅰ stage, he accuracy, sensitivity, specificity, PPV, NPV were 79.9%, 93.1%, 39.5%, 82.4%, 65.2%. Conclusion MRI can be applied as a useful tool in rectal cancer staging. Both T category and nodal metastasis has high sensitivity. But its low specificity may lead to over-staging.

Key words： Rectal cancer MRI Preoperative stage Accuracy

基金资助:国家自然科学基金资助项目（81472257）；
国家临床重点专科建设项目（卫办医政函〔2012〕649号）；
广东省科技计划项目（2010A060801006）。

引用本文:

林伟达骆衍新. MRI在直肠癌术前分期中的准确性分析[J]. 中国医药导报, 2017, 14(28): 113-116.
LIN Weida LUO Yanxin. Analysis of accuracy of preoperative MRI staging. 中国医药导报, 2017, 14(28): 113-116.

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