| Objective:To evaluate the clinical value of OCUS in the examination of gastric lesions,and to provide some help for clinical diagnosis and treatment.Method: Research objects are taken from a total of 61 TUS and OCUS checkings of59 suspicious stomach occupying patients in our hospital from October 2017 to January 2019.On the day of the examination,the patient was kept on an empty stomach to do a normal ultrasound examination,and then the gastrointestinal ultrasound assistant agent was used for examination.Observe the morphology of the stomach,whether the echo of the stomach wall is abnormal,and record the number,location,size,shape,thickness and hierarchical structure of the stomach wall,and the enlarged lymph nodes in the stomach.The pathological results were taken as the gold standard to analyze and compare the sensitivity and specificity of TUS and OCUS for gastric cancer and the overall judgment accuracy of metastatic lymph nodes of gastric cancer.The typing accuracy of advanced gastric cancer Borrmann using OCUS was analyzed.Finally,the ROC curve was drawn according to OCUS measurement of gastric wall thickness,and the diagnostic value of OCUS for gastric cancer was derived from the area of under the curve.Result: The pathology was taken as the gold standard,among the 61 gastric lesions in the 59 patients,9 were benign lesions(gastric polyps and gastric ulcers),50 were gastric cancer,and 2 were gastric stromal tumors.Among the 50 gastric cancers,there were 10 early gastric cancers,40 advanced gastric cancers,2 Borrmann ?,21 Borrmann ?,12 borrmann ?and 5 borrmann ?.Three gastric cancer lesions were located at the fundus,four were located on the greater curveture of the stomach,one was located on the lesser curvature of the stomach,four were located in the gastric angle,28 were located on the gastric antral,and 10 were located in the cardia of stomach.The sensitivity of TUS for the diagnosis of gastric cancer is 40%,the specificity is 72.7%,and the sensitivity of OCUS for the diagnosis of gastric cancer is86%,and the specificity is 81.8%.The difference between the two methods was statistically significant(P<0.05).The overall accuracy of TUS for lymph nodes was about 52.0%(16/50),and the overall accuracy of OCUS for lymph nodes was about62.0%(31/50).The difference between the two was statistically significant(P<0.001).The detection rate of OCUS for early gastric cancer is about 60%(6/10),the detection rate of advanced gastric cancer is 92.5%(37/40),and the overall accuracy rate for Borrmann classification of advanced gastric cancer is 85%(34/40).The accuracy rates of Borrmann?,?,?,and?were 100%(2/2),85.7%(18/21),83.3%(10/12),and 80%(4/5).The ROC curve was drawn by measuring the thickness of the stomach wall with OCUS.The area under the curve was 0.842.When the thickness of the stomach wall was 7.9 mm,the sensitivity and specificity of gastric cancer were the best.The sensitivity was 72% and the specificity was 88.9%.Conclusions: OCUS can greatly improve the diagnostic rate of ultrasound in the treatment of gastric lesions,and can be used for the screening of gastric diseases and the follow-up observation of benign diseases of the stomach. |
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