线性阵列超声内镜与螺旋计算机断层扫描在壶腹周围恶性肿瘤分期中的比较。

Comparison of linear array endoscopic ultrasound and helical computed tomography for the staging of periampullary malignancies.

作者信息

Rivadeneira David E, Pochapin Mark, Grobmyer Stephen R, Lieberman Michael D, Christos Paul J, Jacobson Ira, Daly John M

机构信息

Department of Surgery, New York Presbyterian Hospital-Cornell Medical Center, New York, USA.

出版信息

Ann Surg Oncol. 2003 Oct;10(8):890-7. doi: 10.1245/aso.2003.03.555.

DOI:10.1245/aso.2003.03.555

PMID:14527907

Abstract

BACKGROUND

The purpose of this study was to compare linear array endoscopic ultrasound (EUS) and helical computed tomography (CT) scan in the preoperative local staging evaluation of patients with periampullary tumors.

METHODS

Patients evaluated with EUS and CT for suspected periampullary malignancies from 1996 to 2000 were analyzed. Surgical/pathology staging results were the reference standard.

RESULTS

Forty-eight patients (28 men and 20 women; mean age, 62 +/- 4.9 years; range, 18-90 years) were identified. Malignancy was histologically confirmed in 44 patients. Parameters evaluated included tumor size, lymph node metastases, and major vascular invasion. EUS was significantly more sensitive (100%), specific (75%), and accurate (98%) than helical CT (68%, 50%, and 67%, respectively) for evaluation of the periampullary mass (P <.05). In addition, EUS detected regional lymph node metastases in more patients than helical CT. Sensitivity, specificity, and accuracy of EUS were 61%, 100%, and 84%, in comparison to 33%, 92%, and 68%, respectively, with CT. Major vascular involvement was noted in 9 of 44 patients. EUS correctly identified vascular involvement in 100% compared with 45% with CT (P <.05).

CONCLUSIONS

Linear array EUS was consistently superior to helical CT in the preoperative local staging of periampullary malignancies.

摘要

背景

本研究旨在比较线阵内镜超声（EUS）和螺旋计算机断层扫描（CT）在壶腹周围肿瘤患者术前局部分期评估中的应用。

方法

分析了1996年至2000年期间接受EUS和CT检查疑似壶腹周围恶性肿瘤的患者。手术/病理分期结果为参考标准。

结果

共纳入48例患者（28例男性，20例女性；平均年龄62±4.9岁；范围18 - 90岁）。44例患者经组织学确诊为恶性肿瘤。评估的参数包括肿瘤大小、淋巴结转移和主要血管侵犯。在评估壶腹周围肿块方面，EUS的敏感性（100%）、特异性（75%）和准确性（98%）显著高于螺旋CT（分别为68%、50%和67%，P <.05）。此外，EUS检测到区域淋巴结转移的患者比螺旋CT更多。EUS的敏感性、特异性和准确性分别为61%、100%和84%，而CT分别为33%、92%和68%。44例患者中有9例发现主要血管受累。EUS正确识别血管受累的比例为100%，而CT为45%（P <.05）。