食管腔内超声食管癌术前分期评价

目的 评价腔内超声(EU)对食管癌术前分期的准确性.方法30例食管癌患者术前进行EU(5MH_z直径 10mm)检查,其中8例(26.7%)因狭窄严重未能对肿瘤进行全面探测.全部患者均接受手术治疗,将术前临床分期.EU分期的结果与术后病理分期进行对比分析.结果 术前临床分期正确率仅为40%.EU对肿瘤外侵程度(T)、区域淋巴结受累情况(N)及术前分期的正确率在全组分别为76.7%、66.7%和70.0%,若去除严重狭窄病例后上升为77.7%、77.7%和77.3%.结论 EU能相当准确地对食管癌进行术前分期,提示肿瘤有无外侵或淋巴结转移,为治疗提供指导.病灶周围炎症反应、肿瘤微转移灶及严重狭窄是影响分期正确性的重要因素.

PREOPERATIVE STAGING OF OESOPHAGEAL CARCINOMA WITH ENDOLUMINAL ULTRA-SONOGRAPHY

PURPOSE To evaluate the accuracy of endoluminal ultrasonography (EU) in preoperative staging of esophageal carcinoma. METHODS 30 esophageal cancer patients were examined preoperatively with blind endoe-sophageal ultrasonic probe (5MHz, 10mm). 8 cases (26. 7%) could not be completely evaluated because of severe stenosis. Comparison was made between EU findings as well as the traditional clinical staging system respectively with pathological TNM staging after surgical resection. RESULTS The accuracy of the traditional clinical staging system was only 40%. With EU the accuracy of T, N and preoperative TNM staging reached 76. 7%, 66.7% and 70. 3% for the whole group. When the obstructed cases were excluded, these figures rose 77. 7%, 77. 7% and 77. 3 % respectively. CONCLUSION EU is highly accurate in the preoperative staging of esophageal carcinoma, especially concerning the extent of tumour invasion and regional lymph node involvement. Major limitations causing misinterpretation are microscopic tumour infiltration, paraesophageal inflammation, and severe stenosis. EU is of important value in directing the selection of therapeutic management of esophageal carcinoma.