Yamamura N, Fukushima S, Nakao K, Nakahara M, Kurozumi K, Imabun S, Tsujimoto M
Department of Surgery, Osaka Police Hospital, Kitayama-cho 10-31, Tennoji-ku, Japan.
World J Surg. 2002 Aug;26(8):1071-3. doi: 10.1007/s00268-002-6671-3. Epub 2002 May 21.
Between 1988 and 1999 a total of 24 patients with differentiated thyroid cancer invading the airway underwent various types of tracheal resection at the Osaka Police Hospital. Preoperative ultrasonographic (US) findings in these patients were compared with postoperative histologic results of the resected specimens to confirm the relation between the preoperative and postoperative diagnoses and to determine the indications for operative procedures. Preoperative US revealed cancer invasion to the adventitia in 2 cases, to the intercartilage space in 13, and to the tracheal mucosa in 9. Histologically, cancer invasion to the adventitia was confirmed in 4, to the intercartilage space in 10, and to the mucosa in 10. Among 13 cancer invasion instances to the intercartilage revealed by US, overdiagnosis occurred in 3 cases and underdiagnosis in 1. The actual overall diagnostic rate by US was 83.3%, which is a great improvement over other available methods. In conclusion, preoperative US findings of the trachea agreed with the histologic findings of the resected specimens, indicating US to be the first choice when making decisions about resecting the trachea and about the operative procedure.
1988年至1999年间，大阪警察医院共有24例分化型甲状腺癌侵犯气道的患者接受了各种类型的气管切除术。将这些患者术前的超声（US）检查结果与切除标本的术后组织学结果进行比较，以确认术前和术后诊断之间的关系，并确定手术操作的适应症。术前超声显示，2例癌侵犯至外膜，13例侵犯至软骨间隙，9例侵犯至气管黏膜。组织学检查证实，4例癌侵犯至外膜，10例侵犯至软骨间隙，10例侵犯至黏膜。在超声显示的13例癌侵犯软骨间隙的病例中，3例存在过度诊断，1例存在漏诊。超声的实际总体诊断率为83.3%，比其他现有方法有了很大提高。总之，气管术前超声检查结果与切除标本的组织学检查结果相符，表明超声是决定气管切除及手术方式时的首选检查方法。
