Staging of Gastric Cancer with Endoscopic Ultrasonography and Endoscopic Mucosal Resection
Staging of Gastric Cancer with Endoscopic Ultrasonography and Endoscopic Mucosal Resection
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内镜超声检查和内镜粘膜切除术对胃癌的分期
DOI：
10.1055/s-2007-1001474
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发表时间：
1998
期刊：
影响因子：
9.3
通讯作者：
K. Saigenji
中科院分区：
文献类型：
--
作者：
M. Kida;S. Tanabe;Maya Watanabe;M. Kokutou;I. Kondou;Y. Yamada;T. Sakaguchi;K. Saigenji
由于发现胃肠道壁可见为与肠壁的组织学层相对应的五层结构，超声内镜（EUS）已成为临床上公认的诊断和评估胃癌局部分期最准确的方法。然而，如何区分肿瘤侵袭与溃疡纤维化，如何检测微侵袭，如何识别恶性淋巴结等问题仍然存在。通过对抑制性胃癌的模式分析，通常可以区分癌症侵袭和溃疡纤维化，除非是溃疡纤维化的微侵袭或扫描不充分。然而，EUS评估转移性淋巴结的敏感性仍然存在问题。内镜下粘膜切除术（EMR）因其微创性在日本被广泛接受为早期胃癌的标准治疗方法。根据我们的数据，总体根治率为68.3%（246例中有168例），其余31.7%的患者额外接受了激光治疗、手术或热探针治疗。无胃癌死亡病例。一些有粘膜下层微侵的病变被EUS错误诊断。在不久的将来，使用三维EUS （3D-EUS）可能会解决这个问题。
Since it was found that the gastrointestinal wall is visualized as a five-layered structure corresponding to the histological layers of the wall, endoscopic ultrasonography (EUS) has become recognized clinically as the most accurate method for diagnosing and assessing the local staging of gastric cancer. However, some problems have remained, including how to differentiate between cancer invasion and ulcer fibrosis, how to detect microinvasion, and how to recognize malignant lymph nodes. Using the pattern analysis for depressed-type gastric cancer, it is usually possible to distinguish between cancer invasion and ulcer fibrosis, except in cases of microinvasion into ulcer fibrosis or inadequate scanning. However, the sensitivity of EUS for evaluating metastatic lymph nodes is still problematic. Endoscopic mucosal resection (EMR) for early gastric cancer has been widely accepted as a standard treatment in Japan due to its minimal invasiveness. According to our data, the overall rate of radical resection was 68.3% (168 of 246), and 31.7% of the remaining patients additionally received laser treatment, surgery, or heater-probe treatment. There were no deaths owing to gastric cancer. Some lesions in which there was microinvasion of the submucosa were incorrectly diagnosed by EUS. It may be possible to solve this problem using three-dimensional EUS (3D-EUS) in the near future.