de Manzoni G, Di Leo A, Pedrazzani C, Castaldini G, Borzellino G, Veraldi G, Cordiano C
First Division of General Surgery, University of Verona, Verona, Italy.
J Surg Oncol. 2001 Nov;78(3):158-61. doi: 10.1002/jso.1141.
In order to improve the accuracy in the assessment of depth of tumor invasion, we performed an ultrasound examination of the resected specimen intraoperatively just after removal by the surgeon (Intraoperative Ultrasonography (IUS). This prospective blind study reports the results obtained with the IUS in the staging of T in a group of 281 patients who underwent curative gastrectomy for gastric cancer.
After the removal by the surgeon, the portion of the stomach harboring the tumor was submitted to ultrasonography with a linear 7.5 Mhz probe. An echo-free standoff pad was placed between the probe and the organ; a second echo-free standoff pad was interposed between the stomach and the support surface. The diagnosis of depth of invasion was based on the degree of disruption of the five-layer sonographic structure of the gastric wall.
The IUS staging of T corresponded to the pathological diagnosis in 256 out of 281 cases (overall accuracy 91.1%). The sensitivity in the different classes of T was, respectively, 91.2 in T1m cases, 83.3 in the T1sm cases, 89.6 in the T2 cases, and 93.5% in the T3 cases.
The IUS on the resected specimen has a high degree of accuracy in the assessment of depth of tumor invasion and seems to be an important advance in the clinical staging of gastric cancer.
为提高肿瘤浸润深度评估的准确性，我们在外科医生切除标本后立即对切除标本进行术中超声检查（术中超声检查，IUS）。这项前瞻性盲法研究报告了在一组281例行胃癌根治性胃切除术患者中使用IUS进行T分期的结果。
外科医生切除后，用7.5MHz线性探头对含有肿瘤的胃部分进行超声检查。在探头与器官之间放置一个无回声间隔垫；在胃与支撑面之间插入第二个无回声间隔垫。浸润深度的诊断基于胃壁五层超声结构的破坏程度。
281例病例中，256例IUS的T分期与病理诊断相符（总体准确率91.1%）。不同T类别的敏感性分别为：T1m病例中为91.2%，T1sm病例中为83.3%，T2病例中为89.6%，T3病例中为93.5%。
对切除标本进行IUS在评估肿瘤浸润深度方面具有高度准确性，似乎是胃癌临床分期的一项重要进展。
