LOCAL STAGING AND ASSESSMENT OF RESECTABILITY IN CARCINOMA OF THE ESOPHAGUS, STOMACH, AND DUODENUM BY ENDOSCOPIC ULTRASONOGRAPHY
LOCAL STAGING AND ASSESSMENT OF RESECTABILITY IN CARCINOMA OF THE ESOPHAGUS, STOMACH, AND DUODENUM BY ENDOSCOPIC ULTRASONOGRAPHY
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DOI：
10.1016/s0016-5107(92)70477-5
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发表时间：
1992-07-01
影响因子：
7.7
通讯作者：
CLASSEN, M
中科院分区：
文献类型：
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作者：
ROSCH, T;LORENZ, R;CLASSEN, M
88例接受手术的食管癌（N = 44）、胃癌（N = 41）和十二指肠癌（N = 3）患者术前接受了内镜超声检查（EUS）。EUS对食管癌T分期和N分期的预测准确率分别为82%和70%，对胃癌的预测准确率分别为71%和75%，对十二指肠恶性肿瘤的预测准确率分别为100%和66%。在食管癌中，T分期的准确性仅略低于不可穿透的肿瘤狭窄（77%）与可穿透癌（84%）。这可能是由于所有不可穿越的肿瘤都处于T3或T4期。EUS在预测T1至T3阶段（对应于RO可切除性（没有肉眼或显微镜下肿瘤残留））的准确性对于远端食管腺癌为92%，对于胃癌为85%。然而，在食管鳞状细胞癌中，RO切除仅占所有病例的66%，而EUS预测RO切除率为84%。在远端食管和胃腺癌中，EUS对T1至T3期的预测与RO切除的实际率相关性良好。这些结果表明EUS是上消化道肿瘤局部分期的可靠诊断方法。其对治疗的影响，因此对这些恶性肿瘤患者的预后尚未确定。
Eighty-eight patients with carcinoma of the esophagus (N = 44), stomach (N = 41), and duodenum (N = 3) who underwent surgery were pre-operatively examined by endoscopic ultrasonography (EUS). The ability of EUS to accurately predict the T stage and the N stage was 82% and 70% for esophageal carcinoma, 71% and 75% for gastric cancer, and 100% and 66% for duodenal malignancy. In esophageal carcinoma, the accuracy of T staging was only slightly lower in cases with non-traversable tumor stenoses (77%) compared with traversable carcinomas (84%). This was probably due to the fact that all non-traversable tumors were either in stage T3 or T4. The accuracy of EUS in predicting the stages Tl to T3, which correspond to RO resectability (no macroscopic or microscopic tumor remains), was 92% for adenocarcinoma of the distal esophagus and 85% for gastric cancer. However, in squamous cell carcinoma of the esophagus, RO resection was possible in only 66% of all cases, whereas EUS predicted an 84% RO resection rate. In adenocarcinoma of the distal esophagus and stomach, EUS prediction of stages Tl to T3 correlated well with the actual rate of RO resection. These results show that EUS is a reliable diagnostic method for the local staging of upper gastrointestinal cancer. Its impact on treatment and hence on prognosis of patients with these malignancies has yet to be determined.