Nattermann C, Dancygier H
Medizinische Klinik II, Städtischen Kliniken Offenbach, Akademisches Lehrkrankenhaus, J.W. Goethe-Universität Frankfurt/Main.
Leber Magen Darm. 1992 Sep;22(5):177-83.
Esophageal carcinomas are visualized endosonographically as localized thickenings of the gullet wall with disruption of its echo-layers. The pT-stage is correctly assessed by endosonography in 84% (73-92%). In up to 20% overstaging in the early phases may be caused by accompanying inflammation. The sensitivity for diagnosing local lymph node metastases is 80% (69-90%). The method is well suited for monitoring the course during radio-chemotherapy and for detection of a relapse after operation. At the present time endosonography is the most efficient method in the locoregional staging of esophageal carcinomas. Especially in early tumor stages pT1 and pT2 it is clearly superior to computed tomography. In advanced stages (pT4) in up to 40% of cases marked tumor stenosis, that cannot be passed with the ultrasonic probe, prevents endosonographic staging. However, despite its excellent detail resolution the etiology of a circumscribed wall thickening cannot be determined with absolute accuracy by intraluminal sonography. Based on the echo-pattern inflammatory alterations and scar tissue cannot be definitely distinguished from malignant tumors.
食管癌在超声内镜下表现为食管壁局限性增厚，其回声层中断。超声内镜对pT分期的正确评估率为84%（73%-92%）。在早期阶段，高达20%的分期过高可能是由伴随的炎症引起的。诊断局部淋巴结转移的敏感性为80%（69%-90%）。该方法非常适合在放化疗期间监测病程以及检测术后复发。目前，超声内镜是食管癌局部区域分期中最有效的方法。特别是在肿瘤早期阶段pT1和pT2，它明显优于计算机断层扫描。在晚期（pT4），高达40%的病例存在明显的肿瘤狭窄，超声探头无法通过，这妨碍了超声内镜分期。然而，尽管腔内超声具有出色的细节分辨率，但对于局限性壁增厚的病因，腔内超声无法绝对准确地确定。基于回声模式，炎症改变和瘢痕组织无法与恶性肿瘤明确区分。
