Bergman J J, Fockens P
Department of Gastroenterology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Eur J Ultrasound. 1999 Nov;10(2-3):127-38. doi: 10.1016/s0929-8266(99)00055-5.
For patients with gastro-esophageal cancer ultrasonography (EUS) is superior to any other imaging modality in the assessment of local tumor infiltration and local lymph nodes status. EUS is especially important in the preoperative staging of patients with esophageal cancer and patients with proximal gastric cancer. Here it allows for the identification of those patients with advanced disease who are unlikely to benefit from surgery and in whom a conservative palliative treatment is indicated. In advanced gastric cancer the clinical implications of EUS less clear. Still preoperative EUS is indicated in every patient with cancer of the proximal stomach to assess tumor infiltration in the esophagus. Relatively new is the use of EUS in staging early cancers in order to select patients for local endoscopic treatment. High-frequency miniprobes are the instruments of choice for imaging these lesions. Strict criteria should be applied in the selection of patients for local endoscopic treatment of early gastro-esophageal cancers. EUS guided fine needle aspiration (EUS-FNA) is currently only indicated in patients with esophageal cancer and suspicious celiac lymph nodes. It may become more important if new treatment protocols demand more objective and reliable assessment of lymph node status.
对于胃食管癌患者，在评估局部肿瘤浸润和局部淋巴结状态方面，超声内镜检查（EUS）优于任何其他成像方式。EUS在食管癌患者和近端胃癌患者的术前分期中尤为重要。通过EUS可以识别那些患有晚期疾病、不太可能从手术中获益且需要进行保守姑息治疗的患者。在晚期胃癌中，EUS的临床意义尚不太明确。不过，每位近端胃癌患者术前仍需进行EUS检查，以评估肿瘤对食管的浸润情况。相对较新的应用是EUS用于早期癌症的分期，以便选择适合局部内镜治疗的患者。高频微型探头是对这些病变进行成像的首选器械。在选择早期胃食管癌患者进行局部内镜治疗时应应用严格的标准。目前，EUS引导下细针穿刺抽吸术（EUS-FNA）仅适用于患有食管癌且腹腔淋巴结可疑的患者。如果新的治疗方案需要对淋巴结状态进行更客观可靠的评估，EUS-FNA可能会变得更加重要。
