ENDOSONOGRAPHIC FEATURES PREDICTIVE OF LYMPH-NODE METASTASIS
ENDOSONOGRAPHIC FEATURES PREDICTIVE OF LYMPH-NODE METASTASIS
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DOI：
10.1016/s0016-5107(94)70206-3
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发表时间：
1994-07-01
影响因子：
7.7
通讯作者：
VANDAM, J
中科院分区：
文献类型：
--
作者：
CATALANO, MF;SIVAK, MV;VANDAM, J
对100例食管癌患者的超声内镜特征进行了评价，这些特征被认为是淋巴结转移的特征。受试者接受术前内镜超声检查，以评估肿瘤浸润深度（T分期）和淋巴结转移（N分期）。根据以下参数评价内镜超声成像的淋巴结：大小、形状、边界划分和中央回声模式。当采用严格的标准时，超声内镜检测淋巴结转移的敏感性和特异性分别为89.1%和91.7%。当淋巴结进行超声内镜成像时，无论具体特征如何，N1疾病的可能性为86%，而当没有淋巴结成像时，NO疾病的可能性为79%。超声内镜特征预测恶性肿瘤的重要性依次为低回声（低回声）结构、边界清晰、圆形轮廓和大于10 mm的大小。总的来说，EUS特征在预测恶性淋巴结受累的准确性方面产生了累加效应;当所有四个特征都存在时，恶性肿瘤的预测准确率为100%。这些结果表明，仔细和系统的方法，内镜超声评估淋巴结转移可以提高分期的准确性。
Endosonographic features that are thought to characterize lymph node metastasis were evaluated in 100 patients with esophageal carcinoma. Subjects underwent preoperative endoscopic ultrasonography to assess depth of tumor invasion (T stage) and lymph node metastasis (N stage). Endosonographically imaged lymph nodes were evaluated according to the following parameters: size, shape, border demarcation, and central echo pattern. Sensitivity and specificity of endosonography in detecting lymph node metastasis were 89.1% and 91.7%, respectively, when stringent criteria were used. When lymph nodes were imaged endosonographically, regardless of the specific features, the likelihood of N1 disease, was 86%, whereas when no lymph nodes were imaged, the chance of NO disease was 79%. Endosonographic features predictive of malignancy in increasing order of importance were echo-poor (hypoechoic) structure, sharply demarcated borders, rounded contour, and size greater than 10 mm. Collectively, the EUS features produced an additive effect with respect to accuracy in the prediction of malignant lymph node involvement; malignancy could be predicted with 100% accuracy when all four features were present. These results demonstrate that a careful and systematic approach to the endosonographic assessment of lymph node metastasis can improve staging accuracy.