Abstract: Objective:To investigate the value of the threedimensional endorectal ultrasonography (3DERUS) in the tumor staging before transanal endoscopic microsurgery (TEM).
Methods:The clinical data of 30 patients with rectal cancer who underwent 3DERUS before TEM at the Nanjing Hospital of Traditional Chinese Medicine from April 2012 to December 2013 were retrospectively analyzed. The accuracy, sensitivity and specificity of the 3DERUS were evaluated according to the results of the postoperative pathological examination. The consistency of the results of the 3DERUS and postoperative pathological examination were compared by Kappa consistency test.
Results:Of 30 patients, 25 patients in stage T0, 3 in stage T1 and 2 in stage T2 were diagnosed by preoperative 3DERUS. There were 2 patients (stage pT0) with inflammatory polyp by postoperative pathological diagnosis, 6 patients (stage pT0) with tubular adenoma, 16 patients (stage pT0) with villioustublar adenoma, 2 patients (stage pTis) with carcinoma in situ, 2 patients (stage pT1) with rectal adenoma and 2 patients (stage pT2) with rectal adenoma. There were 2 patients with excessive tumor staging by 3DERUS, 1 patient in stage pT0 was misdiagnosed in stage T1, 1 in stage pT1 was misdiagnosed in stage T2 and 1 in stage pT2 was misdiagnosed in stage T1 with insufficient tumor staging. The accuracy of 3DERUS in the preoperative tumors staging of TEM was 90.0% compared with the resuls of postoperative pathological examination. The accuracy, sensitivity and specificity of 3DERUS in stage pT0, pT1, and pT2 of TEM were 96.7%, 90.0%, 93.3% and 96.2%, 50.0%, 50.0% and 100.0%, 92.8%, 96.4%, respectively. There was a significant difference in the consistency between preoperative 3DERUS and postoperative pathological examination (κ=0.685, P<0.05).
Conclusion 3DERUS is an accurate clinical method in the preoperative tumors staging of TEM, and can be used as the pre operative assessment for TEM.