评价超声双重造影、超声内镜在胃癌术前区域淋巴转移（N分期）中的价值。

2015年6月至2016年9月温州医科大学附属第二医院收治的经胃镜证实为胃癌并进行手术治疗的患者65例。所有患者于术前5 d内均行超声双重造影、超声内镜检查。以组织病理学结果作为金标准，计算超声双重造影、超声内镜判断胃癌术前区域淋巴转移（N分期）的敏感度、特异度及Youden指数。采用χ²检验比较超声双重造影、超声内镜判断胃癌术前区域淋巴转移（N分期）总的符合率差异。

病理证实25例患者为N（-）期，40例患者为N（＋）期。25例N（-）期患者，超声双重造影判断正确18例，超声内镜判断正确20例；40例N（＋）期患者，超声双重造影判断正确32例，超声内镜判断正确31例。超声双重造影、超声内镜判断胃癌术前区域淋巴转移（N分期）的敏感度、特异度及Youden指数分别为80.0%、72.0%、0.52，77.5%、80.0%、0.58；总的符合率分别为76.9%（50/65）、78.5%（51/65），两者差异无统计学意义（χ²=0.044，P =0.833）。

超声内镜和超声双重造影判断胃癌术前N分期总的准确率相当，两种检查方法在胃癌术前N分期中各有优缺点，联合两种检查方法可相互弥补不足，增加胃癌术前N分期判断准确率，对手术治疗方案的制定有指导意义。

To evaluate the accuracy of double contrast-enhanced ultrasonography (DCUS) and endoscopic ultrasonography (EUS) in the preoperative N staging of gastric cancer.

Between June 2015 and September 2016, a total of 65 consecutive patients who were diagnosed with histologically confirmed gastric carcinoma and underwent surgery in the 2^nd Affiliated Hospital of Wenzhou Medical University were enrolled into this study. DCUS and EUS were performed in all patients to estimate lymph node metastasis (N stage) within 5 days before surgery. The findings of the histopathologic examination of resected specimens were considered as gold standard and were retrospectively compared with the results of DCUS and EUS. The sensitivity, specificity and Youden index of DCUS and EUS were calculated. The difference of diagnostic performance between DCUS and EUS was assessed by chi-square test.

There were 25 N- patients and 40 N+ patients confirmed by pathology. Of all 25 N- cases, 18 cases were diagnosed correctly by DCUS and 20 cases were diagnosed correctly by EUS; Of all 40 N+ cases, 32 cases were diagnosed correctly by DCUS and 31 cases were diagnosed correctly by EUS. The sensitivity, specificity and Youden index of DCUS were 80.0%, 72.0% and 0.52 respectively. The sensitivity, specificity and Youden index of EUS were 77.5%, 80.0% and 0.58 respectively. The overall accuracy of DCUS and EUS in N-staging were 76.9% (50/65) and 78.5% (51/65). There was no significant difference between two methods (χ²=0.044, P=0.833).

There was no significant difference between DCUS and EUS in overall N-staging of gastric cancers. Either of these two methods had its advantages and disadvantages. When the two methods were combined, the accuracy of preoperative N-staging of gastric cancers could be improved and this improvement may influence treatment algorithms.