Peritumoral tissue reaction at transrectal US as a possible cause of overstaging in rectal cancer: Histopathologic correlation
Peritumoral tissue reaction at transrectal US as a possible cause of overstaging in rectal cancer: Histopathologic correlation
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DOI：
10.1148/radiology.203.3.9169705
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发表时间：
1997-06-01
期刊：
影响因子：
19.7
通讯作者：
Lechner, GL
中科院分区：
文献类型：
--
作者：
Maier, AG;Barton, PP;Lechner, GL
目的：探讨经直肠超声(TRUS)对肿瘤周围组织反应(PTR)与肿瘤的鉴别诊断价值。材料与方法：对40例经直肠活检证实的直肠癌患者的术前经直肠超声检查结果与手术标本的病理结果进行对比分析。为了避免假设，在研究1中，比肿瘤更无回声的区域被认为是导致不正确分期的原因，对另外40名连续的患者进行了前瞻性研究(研究2)。结果：在研究1中，40例直肠癌中，28例(70%)TRUS分期正确。在7起夸大的案件中，有6起是PTR造成的误解。在研究2中，40例癌症中38例(95%)分期正确，39例(98%)描述了PTR的存在或不存在。PTR的组织病理学分级与TRUS测量的厚度呈显著正相关(P=0.0001)。结论：由于PTR的无回声表现，TRUS可与肿瘤鉴别。由于避免了高估，这可能会导致TRUS在直肠癌分期中具有统计上显著更高的准确性。
PURPOSE: To assess if peritumoral tissue reaction (PTR) can be differentiated from tumor with transrectal ultrasound (TRUS) to avert overstaging.MATERIALS AND METHODS: Preoperative TRUS results in 40 consecutive patients with biopsy-proved rectal cancer were compared with histopathologic reports on the specimens (study 1). To lest the hypothesis that areas more anechoic than the tumor were deemed responsible for incorrect staging in study 1, a prospective study was undertaken in another 40 consecutive patients (study 2). The thickest part of PTR was measured, and results were compared with the histopathologic findings.RESULTS: In study 1, 28 (70%) of 40 rectal cancers were staged correctly with TRUS. PTR was responsible for the misinterpretation in six of seven overstaged cases. In study 2, 38 (95%) of 40 cancers were staged correctly, and the presence or absence of PTR was described in 39 cases (98%). A statistically significant positive correlation was noted between histopathologic classification of PTR and its thickness measured with TRUS (P = .0001).CONCLUSION: Because of its more anechoic appearance, PTR may be differentiated from the tumor by means of TRUS. This may lead to a statistically significantly higher accuracy of TRUS in the staging of rectal cancer due to the avoidance of overstaging.