The Diagnostic Value Of Transabdominal Ultrasound After Oral Administration Of An Echoic Gastric Ultrasound Contrast Agent In TNM Staging Of Gastric Carcinoma

【Purpose】TUS-OCCA is short for transabdominal ultrasound after oral administration ofan echoic cellulose-based gastric ultrasound contrast agent. With the stomach filledwith contrast agent, the gas in the stomach can be excluded. Nowadays, thisexamination is not very widespread, and this study is meant to evaluate the diagnosticvalue of TUS-OCCA in preoperative TNM staging of gastric cancer so that topromote the clinical recognition to this examination.【Methods and materials】50cases in which gastric cancer had been demonstrating by gastroscopic biopsyunderwent TUS-OCCA within a week before operation, and observe the size, shape,invasive depth of tumor, and also the lymphatic and distant metastasis by2-dimentionultrasound. Estimate the TNM staging of these cases according to the standard madeby The international union of anti-cancer/American joint committee on cancer（UICC/AJCC）. Regard the postoperative pathologic staging as gold standard andcompare the ultrasound results with it. Calculate Kappa statistic of T, N, M stagingrespectively between the ultrasound results and gold standard to evaluate theirconsistency (Kappa≥0.75as good consistency,0.75＞Kappa≥0.04as generalconsistency and Kappa＜0.4as poor consistency). Evaluate the diagnostic value ofTUS-OCCA in preoperative TNM staging of gastric cancer. The statistics of data inthis article is all computed by SPSS19. 【Results】Compare the results of both TUS-OCCA and postoperative pathologic staging:TUS-OCCA diagnose5cases of the9T1cases, the accuracy of T1staging were55.6％（5/9）, another2cases were misdiagnosed as T2and another2cases weremisdiagnosed as T3in the other4cases. TUS-OCCA diagnose6cases of the11T2cases, the accuracy of T2staging were54.5％（6/11）, another4cases weremisdiagnosed as T3and another1case was misdiagnosed as T4in the other5cases.TUS-OCCA diagnose15cases of the19T3cases, the accuracy of T3staging were78.9％（15/19）, the other4cases were misdiagnosed as T4. TUS-OCCA diagnose10cases of the11T4cases, the accuracy of T4staging were90.9％（10/11）, the other1cases was misdiagnosed as T3. The total accuracy of T staging were72％（36/50）andthe Kappa statistic of T staging between TUS-OCCA and gold standard is0.608, andthe consistency between them is general.TUS-OCCA diagnose10cases of the13N0cases, the accuracy of N0stagingwere76.9％（10/13）, another1case was misdiagnosed as N1and another2caseswere misdiagnosed as N2in the other3cases. TUS-OCCA diagnose12cases of the15N1cases, the accuracy of N1staging were80％（12/15）, another3cases weremisdiagnosed as N0, N2, N3respectively. TUS-OCCA diagnose13cases of the16N2cases, the accuracy of N2staging were81.3％（13/16）, another2cases weremisdiagnosed as N3and another1case was misdiagnosed as N1in the other3cases.TUS-OCCA diagnose6cases of the6N3cases, the accuracy of N3staging were100％（6/6）. The total accuracy of N staging were82％（41/50）and the Kappastatistic of N staging between TUS-OCCA and gold standard is0.755, and theconsistency between them is good.The diagnosis results of M staging between TUS-OCCA and gold standard werecompletely consistent.【Conclusion】1. TUS-OCCA has the advantages of high detection rate, high diagnosticaccuracy, painless and non-invasive, repeated application. 2. TUS-OCCA has a general accuracy in estimating the T staging of gastriccancer.3. TUS-OCCA has a high accuracy in estimating the N and M staging ofgastric cancer.4. TUS-OCCA can become a routine examination of gastric cancer screeningand preoperative TNM staging.