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目的 评价超声微型探头（mini-probe-sonography,MPS)对大肠癌术前分期的应用价值。方法 对50例大肠癌病人进行前瞻性的术前肠镜下MPS检查,全部病人进行手术治疗,将术前分期与术后病理结果进行对比分析。结果 MPS对肿瘤浸润程度（T）的符合率T1、T2、T3、T4分别为75％、80％、88％、67％,总符合率为84％（P＜0．01）。区域淋巴结受累程度（N）的敏感性为79％,特异性为91％,阳性预测值为92％,阴性预测值为77％,总符合率为84％（P＜0．01）。结论 MPS对大肠癌提供较为准确的术前分期,提示肿瘤浸润程度及淋巴结转移,对制定治疗方案有指导意义。     

肠镜检查对大肠癌术前分期及指导治疗的意义

目的 探讨肠镜检查对大肠癌诊断及术前分期的价值,并评价术前确定大肠癌分期对指导治疗的意义。方法 通过系统地采用电子结肠镜、放大电子肠镜、超声大肠镜检查,对28例大肠癌患者进行了术前分期,并制定了相应的治疗方案。结果 本组资料28例经系统的肠镜检查诊断,分为早期癌组15例,进展期癌组13例,术前分期与术后病理的符合率为100％;浸润深度与病理诊断的符合率为89％（25／28）。早期癌组中,11例病变局限于粘膜层,4例局限于粘膜下层,对其中6例距肛门小于6cm的早期直肠癌患者,选择了肠镜下切除或局部手术切除的治疗方法,至目前随访12－40个月,肠镜检查均无复发。结论 术前对大肠癌正确的临床分期在治疗选择,特别是早期癌的治疗选择方面具有指导意义。在强调治愈性切除的基础上,使大肠癌的手术治疗更具个体化和科学性,从而提高患者的术后生存质量。     

结直肠充气螺旋 CT对结直肠癌术前分期的诊断价值

目的探讨结直肠充气螺旋CT扫描对结直肠癌术前分期的诊断价值。方法从1998年8月至2002年12月,对术前64例经结肠镜活检证实的结直肠癌患者进行结直肠充气,然后行螺旋CT扫描,采用Dukes分期法,将螺旋CT分期结果与手术和病理结果对照。结果结直肠充气螺旋CT图像能清晰地显示全部结直肠肿块,对浆膜层浸润的敏感性为95.2%(40/42),特异性为40.9%(9/22),准确性为76.6%(49/64);判断淋巴结有无转移的敏感性为75.0%(15/20),特异性为90.9%(40/44),准确性为85.9%(55/64);总的分期准确性为64.1%。结论结直肠充气螺旋CT对结直肠癌术前分期有一定的诊断价值和局限性。     

Intraoperative ultrasonography in detecting and assessment of colorectal liver metastases.

OBJECTIVE: to assess the clinical value of intraoperative ultrasonography (IOUS) in detecting and assessment of liver metastatic tumours in colorectal cancer patients. METHODS: a study is a retrospective analysis of 388 patients operated on for colorectal carcinoma between 1997 and 2004. In all the patients intraoperative ultrasound was performed. The authors analyzed of sensitivity, specificity, PPV, NPV and accuracy of pre- and intraoperative ultrasonography in detecting and staging of colorectal metastatic lesions. RESULTS: Intraoperative ultrasonography showed the highest sensitivity, specificity and accuracy in both, tumor detection (99.1, 98.5 and 98.9%, respectively) and assessment (95.4, 99.5 and 99.1%, respectively). Overall sensitivity of IOUS was significantly better in detection and staging compared with preoperative ultrasonography 91.1 and 72.2%, respectively). CONCLUSIONS: IOUS should be used as routine diagnostic modality in colorectal cancer patients with hepatic metastases or suspected metastases. Transabdominal ultrasonography cannot be used as the only diagnostic tool in the evaluation of liver lesions, but may be helpful in preoperative screening.     

多层螺旋CT在结肠直肠肿瘤诊断中的临床应用研究

目的:研究和评价多层螺旋CT(multi-spiral computed tomography,MSCT)在结肠直肠肿瘤诊断中的临床应用和价值。方法:收集仁济医院普外科2004年至2009年接受手术的326例结肠直肠肿瘤病人。①选取其中284例和264例分别进行MSCT结肠定位、定性诊断,并与X线钡剂灌肠及电子肠镜检查的结果进行对比;②取其中75例结肠癌病人同时接受常规放射剂量与低放射剂量结肠MSCT检查,并比较两者在结肠成像上的差别;③运用低放射剂量CT对84例结肠肿瘤病人进行TNM分期,并与其术后病理结果进行对比分析。结果:①在264例同时接受MSCT与钡剂灌肠的结肠直肠肿瘤病人中,MSCT的定位准确率为96.2%(254/264),钡剂灌肠的定位准确率为89.4%(236/264);284例同时接受MSCT与电子肠镜检查的结肠直肠肿瘤病人的MSCT的定位准确率为94.0%(267/284),而其电子肠镜的定位准确率达90.1%(256/284)。可见,MSCT对结肠直肠肿瘤的定位准确率高于钡剂灌肠和电子肠镜。在结肠直肠肿瘤定性诊断中,结肠直肠MSCT的诊断率(87.5%)高于钡剂灌肠(85.2%),而低于电子肠镜检查(95.4%),但差异尚无统计学意义。②对75例同时接受常规剂量结肠CT和低剂量CT检查病人的的成像质量进行对比,结果显示两者无明显差异(P0.05)。③低剂量结肠CT在结肠术前TNM分期诊断准确率为79.8%,与术后病理比较,并无统计学差异(P0.05)。④术后对32例结肠直肠肿瘤病人随访2年,MSCT发现其中6例出现肿瘤复发和转移。结论:MSCT在结肠直肠肿瘤的术前定位、定性及术前分期诊断中具有较高的准确率,并在术后随访中发挥重要作用。低剂量结肠CT的放射剂量大幅降低,安全性提高,结合仿真结肠镜和展平显示技术能基本满足结肠直肠病变的筛查和分期要求。     

早期大肠癌的诊断及治疗

目的 探讨术前诊断早期大肠癌的方法,并评价其对选择治疗方式的意义。方法 经电子、放大、超声结肠镜观察１５例大肠癌患者肿瘤的大体形态、染色后粘膜腺体开口大小排列特点、肿物浸润深度及淋巴结转移情况,据此对患者进行诊断和临床分期,并制定治疗方案。结果 患者肿瘤直径１～６ｃｍ,以亚有蒂型最多,占５３％（８／１５）;放大内镜观察腺体开口最多见的类型为ⅢＬ加Ⅴ型（８例,５３％）;超声内镜观察粘膜癌１１例,粘膜     

多层螺旋CT在胃癌术前分期中的临床应用

目的探讨多层螺旋CT（MSCT）在胃癌术前分期中的临床应用价值。方法2004年6月至2006年3月间经胃镜活检确诊为胃癌的患者89例，其中男性49例，女性40例，中位年龄63岁。所有患者均在手术前1周内进行MSCT检查。图像由2位资深放射科医师双盲阅读，术前判断患者的肿瘤TNM分期．并与患者的术后病理结果进行对照比较。结果与术后病理诊断比较，MSCT普通轴位图像结合多平面重建法判断胃壁侵犯程度的总准确率为72．3％，其中T1判断准确率为90．0％，T2为82．8％，T3为69．6％，T4为52．4％；判断淋巴结转移情况的总准确率为53．0％，其中N0判断准确率为44．0％，N1为72．0％，N2为46．4％，N3为2／5。MSCT对有远处转移即M1的患者判断准确率为90．0％。结论MSCT对胃癌患者进行术前TNM分期有较高的准确率，可以为胃癌患者术前提供一种无创且易于被接受的检查方法。     

直肠腔内超声对直肠癌术前分期的临床价值

目的探讨直肠腔内超声(TRUS)对评估直肠癌术前分期的临床价值。方法对118例经肠镜活检病理证实为直肠癌患者行TRUS检查,观察肿块内部回声、肿瘤浸润肠壁深度及与周围组织器官的关系,根据TN分期标准进行术前分期,并与术后病理分期进行对照。结果 TRUS评估直肠癌T分期完全符合率为86.4%(102/118),T1~T4的敏感度分别为80.0%、82.3%、91.6%、83.9%和特异度分别为100.0%、90.4%、90.0%、98.8%;Kappa值为0.734,超声分期与病理分期高度一致(P0.05),对评估淋巴结转移的灵敏度为81.4%(79/97),特异度为71.4%(15/21)。结论 TRUS对评估直肠癌浸润深度及淋巴结转移等有较高的准确性,为治疗方案的选择提供可靠的参考信息。     

Preoperative measurement of tumor thickness of oral tongue carcinoma with intraoral ultrasonography

BACKGROUND: Tumor thickness of oral tongue carcinoma is an important independent prognostic factor for local recurrence, subclinical nodal metastasis, and survival. An accurate preoperative assessment of tumor thickness is therefore essential in optimizing treatment algorithm. The present study aims at evaluating the accuracy of intraoral ultrasonography in preoperative measurement of tumor thickness. METHODS: Forty-five patients with oral tongue carcinoma had intraoral ultrasonography to document tumor thickness using a 7.5 MHz right angle probe. The ultrasonic tumor thickness was correlated with the fresh unpreserved surgical specimen pathologic tumor thickness. RESULTS: Ultrasonic tumor thickness had significant correlation with pathologic tumor thickness. The accuracies of ultrasonic measurement of tumor thickness in staging of tumor thickness at cutoff values between 3 and 15 mm were above 91%. CONCLUSION: Intraoral ultrasonography had satisfactory accuracy in the measurement of tumor thickness and is a useful adjunct in assisting pretreatment staging and prognosis evaluation of oral tongue carcinoma.     

内镜超声检查和多层螺旋CT对胃癌术前T、N分期的比较研究

目的探讨内镜超声(endoscopicultrasonography,EUS)与多层螺旋CT(multi slicespiralCT,MSCT)在胃癌术前T、N分期中的临床应用价值。方法2000年10月至2002年5月,对89例活检证实的胃癌病人术前分别行内镜超声和多层螺旋CT检查,并与手术病理结果对照。结果EUS对胃癌术前T分期的准确率为75.6%,其中T176.5%,T268.8%,T384.4%,T464.7%;MSCT分别79.3%,58.8%,62.5%,90.6%和94.1%。两者差异无统计学意义(P>0.05)。EUS对胃癌术前N分期的准确率为57.5%,其中N095.8%,N145.8%,N232.0%;MSCT分别78.1%,70.8%,75.0%和88.0%。EUS和MSCT对胃癌淋巴结转移的敏感性分别为61.2%和91.8%。EUS对N0分期的准确率显著高于MSCT(P<0.05),MSCT对N和N2分期的准确率及淋巴结转移的敏感性均显著高于EUS(P<0.05,P<0.01,P<0.01)。结论内镜超声检查与多层螺旋CT对胃癌术前TN分期均有较高的准确性。     

Endosonography of upper gastrointestinal tract cancer on demand using miniprobes or endoscopic ultrasound

BACKGROUND: The aim of this study was to investigate whether endosonography on demand with miniprobes and conventional endoscopic ultrasound improves the accuracy of endosonographic staging of upper gastrointestinal tract cancer. METHODS: Altogether, 173 patients underwent endoscopic ultrasonography for preoperative staging of esophageal (n = 63) or gastric cancer (n = 110). Depending on the endoscopic appearance (i.e., size and growth pattern), tumors were examined with a linear-array echoendoscope (7.5 MHz) or with high-resolution miniprobes (12.5 MHz). The results of preoperative staging were correlated with histopathology of the resection specimen. RESULTS: The overall accuracy of miniprobe ultrasonography and endoscopic ultrasound in assessing the infiltration depth of upper gastrointestinal cancer was 87% and 81%, respectively. Miniprobe ultrasonography was superior to conventional endoscopic ultrasound in the staging of early cancers, particularly T1 tumors (accuracy, 81% vs 56%). The combined accuracy of both techniques for all tumor stages was 82%. Correct diagnosis of lymph node involvement was obtained with miniprobe ultrasonography or endoscopic ultrasound in 76% and 71% of the cases, respectively. The combined accuracy in assessing the lymph node status was 73% (sensitivity, 68%; specificity, 81%). CONCLUSIONS: Endosonography on demand using either miniprobes or conventional endoscopic ultrasound may result in more effective and less invasive staging of esophageal and gastric cancer. Selective use of high-resolution miniprobes and conventional endoscopic ultrasound offers accurate staging of all tumor stages.     

胃镜及CT检查对进展期胃癌手术可切除性的探讨

目的 探讨胃镜结合CT检查对进展期胃癌的术前分期及手术治疗的临床指导意义.方法 对182例进展期胃癌的术前胃镜并CT分期与手术结果进行对比.结果 胃镜活检低(未)分化腺癌和黏液腺癌手术切除率(64.1%)较低,弥漫浸润型胃癌的切除率(6.7%)明显低于肿块型(66.7%)和溃疡型(61.8%);CT分期总准确率为91.21%,CT诊断对胃周脏器受侵和(或)转移的敏感性为72.22%,CT对淋巴结分期的准确率为74.2%,敏感性为74.1%,特异性为74.3%,CT诊断对淋巴结分组比较模糊.结论 胃镜在进展期胃癌定性诊断方面有不可取代的优势,对进展期胃痛的大体分型和活检组织学诊断及治疗方式有指导意义.CT诊断对进展期胃癌的临床分期准确性对周围脏器的侵犯、转移及淋巴结转移的诊断均有很高的价值;CT对手术切除情况的判断优于胃镜检查.术前行CT检查,对手术治疗有重要指导意义.     

多层螺旋CT联合血清淀粉样蛋白A术前评估直肠癌在外科决策中的价值

目的 探讨64排多层螺旋CT(MSCT)和血清淀粉样蛋白A(SAA)联合术前评估进行直肠癌术前分期的准确性及其临床应用价值.方法 前瞻性纳入2007年10月至2008年10月期间住院的225例直肠癌患者,将患者随机分为MSCT组和MSCT与SAA联合组,联合组术前行MSCT和SAA联合评估,MSCT组术前只行MSCT评估.分别将两组术前T、N、M、TNM分期准确度进行比较,并比较两组手术方案的预测符合率.结果 本研究实际纳入病例225例,MSCT和SAA联合组110例,MSCT组115例,两组基线情况具有可比性.联合组术前T、N、M和TNM分期的准确度分别为87.3%、85.2%、100%和86.4%,MSCT组的准确度分别为85.2%、67.0%、100%和66.1%;两组术前N分期和TNM分期准确度差异具有统计学意义(P=0.009、0.001).两组手术方案的预测符合率分别为94.7%和81.7%,差异具有统计学意义(P=0.003).结论 MSCT和SAA联合评估的策略可以提高直肠癌患者术前分期N、TNM的准确性,并可提高预测手术方案的符合率.     

多原发结直肠癌168例临床分析

目的 分析研究多原发结直肠癌(MPCC)在结直肠癌中的发生率及其临床病理特征,分析其漏诊原因.方法 对1985年1月至2003年12月收治的168例MPCC病例的临床和病理资料进行回顾性分析.结果 168例MPCC占同期手术治疗结直肠癌的4.6%.其中同时多原发癌(SC)81例,异时多原发癌(MC)72例,SC并MC者15例.首次诊断结直肠癌的年龄为20～82岁,中位年龄58岁.168例中共发生结直肠癌393处(平均每例2.3处),病灶于直肠和乙状结肠多见,占61.6%.其中18例(10.7%)明确为遗传性非息肉病性结直肠癌(HNPCC),9例(5.4%)高度怀疑HNPCC.14例(8.3%)合并其他器官癌,72例(42.9%)为腺瘤癌变,另有41例(24.4%)同时合并腺瘤.96例SC中,术前行纤维肠镜检查91例,65例(71.4%)获得确诊.所有MC病例均为术后纤维肠镜检查发现.全组总体5年生存率为69.8%.结论 纤维结肠镜检查在MPCC的诊断和随访中意义重大,有助于减少SC的漏诊和及时发现MC.对腺瘤的积极治疗有助于减少MPCC的发生.在MPCC中应重视HNPCC的检测和其他器官癌的监测.由于MPCC可以获得和首发癌相同的疗效,应重视积极的、规范化的手术治疗.     

The degree to which accuracy of preoperative staging of laryngeal carcinoma has been enhanced by computed tomography

In this retrospective study, the accuracy of preoperative staging by high-resolution CT and clinical evaluation (indirect-direct laryngoscopy) is compared to the postsurgical pathologic staging of laryngeal cancer. Forty-two patients who were admitted to St. Louis University Hospital between the years of 1978 to 1985 with diagnoses of laryngeal cancer were included. All patients received high-resolution CT scan of the larynx preoperatively and subsequently underwent total or partial laryngectomy. None of these patients received preoperative radiotherapy. The accuracy of the clinical vs. CT staging--as well as the accuracy of the staging by combination of the two modalities--was determined by comparison with the postsurgical pathologic staging. The accuracy was assessed separately for glottic, supraglottic, and transglottic carcinoma. The accuracy of CT staging for glottic carcinoma was 75%. However, clinical evaluation in this group of lesions was very reliable, offering 92.9% accuracy. The accuracy of CT staging increased in the supraglottic and transglottic lesions, to become superior to the clinical staging. With combined information gained by both examinations, the preoperative staging accuracy was 91.4% for supraglottic carcinoma and 87.5% for transglottic carcinoma. It is, therefore, recommended that high-resolution CT should be included in the preoperative staging of laryngeal cancer.     

食管癌术前分期评价——食管腔内超声、计算机断层扫描和传统临床分期比较

目的比较食管腔内超声（ＥＵ）、计算机断层扫描（ＣＴ）和传统临床分期对食管癌术前分期的价值。方法３６例食管癌患者,术前均进行ＥＵ检查,其中８例（２２２％）因管腔严重狭窄未获全面评估。２１例进行了ＣＴ分期。ＥＵ、ＣＴ和传统临床分期结果分别与手术病理分期比较。结果传统临床分期准确率仅为３６％,ＣＴ对肿瘤浸润程度、局部淋巴结受累及ＰＴＮＭ分期的准确率分别为３８１％、５７１％和４７６％,ＥＵ为７７８％、７２２％和７０２％,去除严重狭窄病例后进一步提高至８５７％、７８６％和８３１％。结论食管癌传统分期方法准确性欠佳。ＣＴ能明确显著的肿瘤外浸,并且是除外远处转移的最佳手段,但无法精确区分早、中期肿瘤,因而对手术帮助有限。ＥＵ对于食管癌术前区域分期具有较高的准确性,因此对治疗方法的选择和疗效的改进具有重要价值     

Limitations of computerized tomography in staging invasive bladder cancer before radical cystectomy

PURPOSE: Computerized tomography (CT) of the abdomen and pelvis is often routine in the preoperative staging assessment of invasive transitional cell carcinoma of the bladder. We determine the accuracy of staging CT findings, usefulness before planned extirpative surgery and impact on surgical management of this disease. MATERIALS AND METHODS: We retrospectively reviewed the medical records, including radiographic, operative and pathological reports, of 82 consecutive cases. All patients presented with muscle invasive bladder tumors, were considered candidates for radical cystectomy and underwent preoperative staging CT of the abdomen and pelvis between July 1994 and June 1998. The ability of CT to provide additional staging information in terms of depth of tumor invasion, local extent of tumor, pelvic lymph node involvement and distant metastases was examined. We determined whether CT findings altered surgical management for individual patients. RESULTS: CT was able to discriminate depth of invasion in only 1 patient (1.2%) and correctly identified extravesical tumor spread in 4 (4.9%). Lymph node and distant metastases were accurately determined in 4 (4.9%) and 2 (2.4%) cases, respectively. The overall accuracy of CT was 54. 9%, with an under staging and over staging rate of 39.0% and 6.1%, respectively. CT provided accurate, additional staging information in only 8 cases (9.8%). Surgical management was altered in 3 cases (3.7%) and only 1 (1.2%) avoided an unnecessary operation as a result of CT findings. CONCLUSIONS: Staging CT of the abdomen and pelvis in patients with invasive bladder carcinoma has limited accuracy, mainly because of its inability to detect microscopic or small volume extravesical tumor extension and lymph node metastases. CT tends to under stage advanced disease and failed to alter surgical management in nearly all of our cases.     

中国人 2025例多原发结直肠癌荟萃分析

目的 总结中国人多原发结直肠癌的临床特点。方法 以多原发结直肠癌为检索词,电脑检索1989—2004年国内公开发表的中文文献,统一纳入和排除标准,所得资料进行荟萃分析。结果 （1）发病率2．9％,有癌家族史13．1％,平均患病年龄53岁;（2）同时性多原发结直肠癌术前纤维结肠镜诊断率55．2％,术中探查诊断率37．5％,术后标本诊断率15．7％;（3）异时性多原发结直肠癌术前纤维结肠镜诊断率94．8％,平均间隔时间5．2年;（4）癌灶部位：直肠30．9％,乙状结肠19．9％,降结肠9．O％,结肠脾曲5．2％,横结肠9．1％,结肠肝曲6．1％,升结肠11．8％,盲肠8．1％;（5）伴肠外癌灶37．6％,伴腺瘤或息肉43．7％,有淋巴结转移34．6％;（6）组织学类型相同者60．6％,不相同者39．4％,腺癌89．2％,腺瘤或息肉恶变8．4％;（7）根治性切除85．9％,姑息性切除10．1％;（8）术后3、5、10、15年生存率,同时性多原发结直肠癌分别为64．3％、44．6％、26．3％和9．4％,异时性多原发结直肠癌分别为69．6％、59．2％、45．0％和36．7％,两组比较,分别P〉0．05、P〈0．05、P〈0．01和P〈0．01。结论 多原发结直肠癌临床少见,诊断主要靠纤维结肠镜检和术中探查;根治性切除率高;预后良好,且异时性多原发结直肠癌优于同时性多原发结直肠癌。     

胃双重超声造影结合血清巨噬细胞炎症蛋白1与血管细胞黏附分子1检测对胃癌术前分期的价值

目的:探讨胃双重超声造影(DCEUS)联合血清巨噬细胞炎症蛋白1(MIP-1)与血管细胞黏附分子1(VCAM-1)检测对胃癌术前分期的临床价值。方法:685例胃癌患者术前行胃镜和DCEUS检查并进行术前分期,同时运用ELISA法检测术前血清MIP-1与VCAM-1水平,根据术后病理分期,比较DCEUS与DCEUS联合MIP-1与VCAM-1检测对胃癌术前分期判断准确性。结果:DCEUS对胃癌T分期判断的敏感性(特异性)分别为T1 93.10%(92.05%)、T2 67.47%(65.50%)、T3 78.62%(80.47%)、T4 91.41%(90.70%),总准确率为80.15%;对N分期判断的敏感性(特异性)分别为N0 90.55%(80.99%)、N1 63.57%(73.87%)、N2 88.40%(92.50%)、N3 82.35%(73.68%),总准确率为82.92%;对M分期判断的敏感性(特异性)分别为:M0 99.29%(84.82%)、M1 71.48%(98.43%),总准确率为88.61%。血清MIP-1和VCAM-1水平与胃癌组织浸润程度、淋巴结转移、远处转移和病理分期均有关(均P0.05)。DCEUS联合MIP-1、VCAM-1检测对T分期判断的敏感性(特异性)分别为T1 93.10%(92.05%)、T2 87.95%(94.19%)、T3 95.07%(92.33%)、T4 91.41%(90.70%),总准确率为92.41%;对N分期判断的敏感性(特异性)分别为:N0 98.43%(96.90%)、N1 89.15%(94.26%)、N2 95.22%(95.22%)、N3 92.65%(89.36%),总准确率为94.16%;对M分期判断的敏感性(特异性)分别为M0 99.76%(97.68%)、M1 96.20%(99.61%),总准确率为98.39%。DCEUS联合MIP-1、VCAM-1检测对判断胃癌T、N、M分期的准确率均明显高于DCEUS(均P0.05)。结论:胃癌的病理分期与血清MIP-1和VCAM-1表达密切相关,DCEUS联合术前检测MIP-1和VCAM-1血清水平,有利于提高胃癌术前分期判断的准确性。     

Is laparoscopic sonography a reliable and sensitive procedure for staging colorectal cancer?

Background: Laparoscopic colectomy has developed rapidly with the explosion of technology. In most cases, laparoscopic resection is performed for colorectal cancer. Intraoperative staging during laparoscopic procedure is limited. Laparoscopic ultrasonography (LUS) represents the only real alternative to manual palpation during laparoscopic surgery. Methods: We evaluated the diagnostic accuracy of LUS in comparison with preoperative staging and laparoscopy in 33 patients with colorectal cancer. Preoperative staging included abdominal US, CT, and endoscopic US (for rectal cancer). Laparoscopy and LUS were performed in all cases. Pre- and intraoperative staging were related to definitive histology. Staging was done according to the TNM classification. Results: LUS obtained good results in the evaluation of hepatic metastases, with a sensitivity of 100% versus 62.5% and 75% by preoperative diagnostic means and laparoscopy, respectively. Nodal metastases were diagnosed with a sensitivity of 94% versus 18% with preoperative staging and 6% with laparoscopy, but the method had a low specificity (53%). The therapeutic program was changed thanks to laparoscopy and LUS in 11 cases (33%). In four cases (12%), the planned therapeutic approach was changed after LUS alone. Conclusions: The results obtained in this study demonstrate that LUS is an accurate and highly sensitive procedure in staging colorectal cancer, providing a useful and reliable diagnostic tool complementary to laparoscopy. Received: 2 May 1997/Accepted: 11 February 1998