Tio T L, Cheng J, Wijers O B, Sars P R, Tytgat G N
Department of Gastroenterology-Hepatology, Amsterdam, The Netherlands.
Gastroenterology. 1991 May;100(5 Pt 1):1351-61.
Endosonography was performed preoperatively in 33 patients with common bile duct carcinoma and in 43 patients with carcinoma of the common hepatic duct and its bifurcation. The results were correlated with the histology of resected specimens according to the new (1987) TNM (tumor, node, metastasis) classification. Endosonography was accurate in the evaluation of the depth of tumor infiltration. Overall accuracy for common bile duct carcinoma and common hepatic duct carcinoma was 82.8% and 85%, respectively. Endosonography was helpful in diagnosing regional lymph node metastases but not accurate in diagnosing nonmetastatic lymph nodes. With common bile duct carcinoma, the incidence of lymph node metastasis increased with progressive depth of tumor infiltration. No such correlation was found in common hepatic duct carcinomas. In the staging of distant metastasis, this technique was limited by the low-penetration depth of ultrasonography. Thus, additional transcutaneous ultrasonography or computed tomography was necessary for complete staging. The routine use of the biopsy channel for endosonographically guided aspiration puncture will further enhance the diagnostic value of endosonography in the future.
对33例胆总管癌患者及43例肝总管及其分叉处癌患者进行了术前超声内镜检查。根据新的（1987年）TNM（肿瘤、淋巴结、转移）分类法，将检查结果与切除标本的组织学结果进行了对比。超声内镜检查在评估肿瘤浸润深度方面较为准确。胆总管癌和肝总管癌的总体准确率分别为82.8%和85%。超声内镜检查有助于诊断区域淋巴结转移，但在诊断无转移淋巴结方面并不准确。对于胆总管癌，淋巴结转移发生率随肿瘤浸润深度的增加而升高。在肝总管癌中未发现这种相关性。在远处转移分期方面，该技术受超声穿透深度低的限制。因此，为了进行完整分期，需要额外进行经皮超声检查或计算机断层扫描。超声内镜引导下穿刺活检通道的常规使用将在未来进一步提高超声内镜检查的诊断价值。
