超声内镜对胆囊癌的术前诊断与分期

Preoperative diagnosis and staging of gallbladder carcinoma by EUS.

作者信息

Sadamoto Yojiro, Kubo Hiroaki, Harada Naohiko, Tanaka Munehiro, Eguchi Takashi, Nawata Hajime

机构信息

Departments of Medicine and Bioregulatory Science, and Surgical Pathology Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

出版信息

Gastrointest Endosc. 2003 Oct;58(4):536-41. doi: 10.1067/s0016-5107(03)01961-8.

DOI:10.1067/s0016-5107(03)01961-8

PMID:14520286

Abstract

BACKGROUND

EUS has recently been shown to be efficacious for the preoperative assessment of depth of invasion of gallbladder carcinoma. This study assessed the value of EUS for determining T stage (International Union Against Cancer).

METHODS

Preoperative EUS findings in 41 patients with gallbladder carcinoma were analyzed retrospectively. EUS images were classified according to the shape of the tumor and the adjacent gallbladder wall structure as follows: type A, pedunculated mass with preserved adjacent wall structures; type B, sessile and/or broad-based mass with a preserved outer hyperechoic layer of the gallbladder wall; type C, sessile and/or broad-based mass with a narrowed outer hyperechoic layer; type D, sessile and/or broad-based mass with a disrupted outer hyperechoic layer. EUS and histopathologic findings were compared, including the depth of invasion of the tumor in the resection specimen.

RESULTS

The 4 categories of EUS images of gallbladder carcinoma correlated with the histologic depth of invasion and T stage. Accuracies for the EUS classification as type A corresponding to pTis, type B to pT1, type C to pT2, and type D to pT3-4 were, respectively, 100%, 75.6%, 85.3%, and 92.7%.

CONCLUSIONS

Preoperative EUS imaging accurately depicts T stage of gallbladder carcinoma and allows for effective therapeutic decision making.

摘要

背景

最近研究显示内镜超声（EUS）在胆囊癌术前浸润深度评估中具有有效性。本研究评估了EUS在确定T分期（国际抗癌联盟）方面的价值。

方法

回顾性分析41例胆囊癌患者的术前EUS检查结果。EUS图像根据肿瘤形状及相邻胆囊壁结构分类如下：A型，有蒂肿块，相邻壁结构保留；B型，无蒂和/或基底较宽的肿块，胆囊壁外层高回声层保留；C型，无蒂和/或基底较宽的肿块，外层高回声层变窄；D型，无蒂和/或基底较宽的肿块，外层高回声层中断。比较EUS和组织病理学检查结果，包括切除标本中肿瘤的浸润深度。