Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Yongun-dong 28, Chongno-gu, Seoul 110-744, South Korea.
Surg Endosc. 2010 Jun;24(6):1380-6. doi: 10.1007/s00464-009-0783-x. Epub 2009 Dec 24.
Endoscopic ultrasonography (EUS) has been a useful method for the accurate staging of esophageal cancer. This study aimed to compare the diagnostic performance of EUS, positron emission tomography (PET), and computed tomography (CT) in the locoregional staging of resectable esophageal cancer.
A total of 109 patients with resectable esophageal cancer were prospectively enrolled and retrospectively reviewed for evaluation of preoperative EUS, PET, and CT. The sensitivity, specificity, and accuracy of tumor depth (T) staging and regional lymph nodal (N) staging for each test were compared with the postoperative histopathologic stage as the gold standard.
The overall accuracy of EUS for T staging was 72%, and it was the only method for delineating the layers of the esophageal wall. The sensitivities for N staging were 42% for EUS, 49% for PET, and 35% for CT, and their specificities were, respectively, 91, 87, and 93%. The accuracy for N staging was 66% for EUS, 68% for PET, and 63% for CT, and it did not differ significantly across the three tests.
Preoperative EUS for the locoregional staging of esophageal cancer provides excellent T staging accuracy and similar accuracy for N staging compared with PET and CT. Especially in T staging, EUS could play an important role in the choice of candidates for esophageal cancer surgery.
内镜超声检查（EUS）已成为一种用于准确分期食管癌的有用方法。本研究旨在比较 EUS、正电子发射断层扫描（PET）和计算机断层扫描（CT）在可切除食管癌局部区域分期中的诊断性能。
共前瞻性纳入 109 例可切除食管癌患者，回顾性评估术前 EUS、PET 和 CT。将每种检查的肿瘤深度（T）分期和区域淋巴结（N）分期的敏感性、特异性和准确性与术后组织病理学分期作为金标准进行比较。
EUS 对 T 分期的总体准确性为 72%，是唯一能够描绘食管壁各层的方法。EUS、PET 和 CT 对 N 分期的敏感度分别为 42%、49%和 35%，特异度分别为 91%、87%和 93%。EUS 对 N 分期的准确性为 66%、PET 为 68%、CT 为 63%，三种检查方法之间无显著差异。
术前 EUS 对食管癌的局部区域分期可提供出色的 T 分期准确性，并与 PET 和 CT 具有相似的 N 分期准确性。特别是在 T 分期方面，EUS 可在食管癌手术候选者的选择中发挥重要作用。
