Nesje L B, Svanes K, Viste A, Laerum O D, Odegaard S
Institutes of Internal Medicine and Surgery, Dept. of Pathology, Haukeland University Hospital, University of Bergen, Norway.
Scand J Gastroenterol. 2000 Sep;35(9):997-1002. doi: 10.1080/003655200750023101.
Endoscopic ultrasonography is a precise method for TN staging of esophageal cancer. We explored the staging properties of a linear miniprobe as compared with a radial-scanning echoendoscope.
Sixty-eight patients with esophageal cancer underwent preoperative TN staging using a 20-MHz linear miniprobe and a 7.5/12-MHz radial-scanning echoendoscope. Tumor stage was verified by surgery and/or histology.
T and N stages were verified in 53 and 54 patients, respectively. T-staging accuracy using the echoendoscope was 70%. The high-frequency miniprobe could not differentiate between T3 and T4 tumors, but both systems had an accuracy of 87% in discriminating between T1, T2, and T3/4 stages. With traversable tumors, the accuracy of N staging was significantly better with the echoendoscope than with the miniprobe (90% vs. 48%, P = 0.008).
The two endosonographic systems had similar accuracy for assessing transmural tumor growth, but the echoendoscope was superior in staging advanced transmural tumors and in predicting lymph node metastasis with traversable tumors.
内镜超声检查是食管癌TN分期的一种精确方法。我们探讨了线性微型探头与径向扫描超声内镜相比的分期特性。
68例食管癌患者术前使用20MHz线性微型探头和7.5/12MHz径向扫描超声内镜进行TN分期。肿瘤分期通过手术和/或组织学进行验证。
分别在53例和54例患者中验证了T和N分期。使用超声内镜的T分期准确率为70%。高频微型探头无法区分T3和T4肿瘤，但两种系统在区分T1、T2和T3/4期时的准确率均为87%。对于可穿透的肿瘤，超声内镜的N分期准确率明显高于微型探头（90%对48%，P = 0.008）。
两种内镜超声系统在评估肿瘤壁外生长方面具有相似的准确率，但超声内镜在晚期壁外肿瘤分期和预测可穿透肿瘤的淋巴结转移方面更具优势。
