Sadamoto Yojiro, Kubo Hiroaki, Harada Naohiko, Tanaka Munehiro, Eguchi Takashi, Nawata Hajime
Departments of Medicine and Bioregulatory Science, and Surgical Pathology Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Gastrointest Endosc. 2003 Oct;58(4):536-41. doi: 10.1067/s0016-5107(03)01961-8.
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).
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.
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%.
Preoperative EUS imaging accurately depicts T stage of gallbladder carcinoma and allows for effective therapeutic decision making.
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。
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。
胆囊癌的4类EUS图像与组织学浸润深度及T分期相关。EUS分类为A型对应pTis、B型对应pT1、C型对应pT2、D型对应pT3 - 4的准确率分别为100%、75.6%、85.3%和92.7%。
术前EUS成像可准确描绘胆囊癌的T分期并有助于做出有效的治疗决策。
