Value of high-frequency miniprobes and conventional radial endoscopic ultrasound in the staging of early Barrett's carcinoma
Value of high-frequency miniprobes and conventional radial endoscopic ultrasound in the staging of early Barrett's carcinoma
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DOI：
10.1055/s-0029-1243839
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发表时间：
2010-02-01
期刊：
影响因子：
9.3
通讯作者：
Ell, C.
中科院分区：
文献类型：
--
作者：
Pech, O.;Guenter, E.;Ell, C.
背景和目标：高频微探头（HFPs）和常规放射状内镜超声检查（crEUS）被认为是早期巴雷特癌分期的有价值的工具。然而，有一些争议是否HFPs是上级的T分期的巴雷特癌症或是否可以通过单独使用crEUS.Patients和方法达到相同的准确性水平：患者转诊为内镜治疗巴雷特癌症包括在这个前瞻性交叉试验，并随机分配到HFPs或crEUS作为初始诊断方法。之后，所有患者均采用替代程序重新检查。结果：共纳入43例患者（中位年龄66岁[四分位数间距：58-73]; 34例男性）。在组织学检查中，共证实了23例粘膜和16例粘膜下巴雷特癌。4例患者无法进行组织学确认。由于定位问题，7%的患者无法使用HFP评估T分类，而crEUS为33%（P < 0.0001）。结论：在Barrett癌的局部分期中，HFP的准确性明显优于crEUS，具有上级的临床应用价值。然而，这两种技术的T类评估的准确性是不令人满意的。
Background and aims: High-frequency miniprobes (HFPs) and conventional radial endoscopic ultrasonography (crEUS) are considered valuable tools in the staging of early Barrett's cancer. However, there is some controversy on whether HFPs are superior in the T staging of Barrett's cancer or whether the same level of accuracy can be achieved by the sole use of crEUS.Patients and methods: Patients referred for endoscopic treatment for Barrett's cancer were included in this prospective crossover trial and were randomly assigned to either HFPs or crEUS as the initial diagnostic method. Afterwards, all of the patients were re-examined with the alternative procedure. The staging results obtained with each method were documented prospectively.Results: A total of 43 patients (median age 66 years [interquartile range: 58-73]; 34-male) were included. A total of 23 mucosal and 16 submucosal Barrett's cancers were confirmed at histology. Histological confirmation was not possible in four patients. Assessment of the T category was not possible with HFPs in 7% of patients, compared with 33% with crEUS (P < 0.0001) due to positioning problems. T category was correctly assessed with HFP in 64% of patients and with crEUS in 49%.Conclusions: HFPs are significantly superior to crEUS for local staging of Barrett's cancer. However, the accuracy of assessment of the T category was unsatisfactory with both techniques.