Tio T L, Coene P P, Luiken G J, Tytgat G N
Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
Gastrointest Endosc. 1990 Mar-Apr;36(2 Suppl):S2-10. doi: 10.1016/s0016-5107(90)71008-5.
Endosonography (ES) was preoperatively performed in 113 patients with esophageal carcinoma (group 1) and in 84 patients with gastric carcinoma (group 2). Results of imaging and histology of resected specimens were correlated according to the new (1987) TNM classification. ES was accurate in assessing the depth of tumor infiltration. Overall accuracy of ES for group 1 was 89% and for group 2 83%. Early carcinomas could be distinguished from advanced cancers. ES was accurate in diagnosing lymph node metastases (sensitivity group 1 95% and group 2 87%) but less accurate in defining inflammatory changes of lymph nodes (specificity group 1 50% and group 2 48%). The incidence of lymph node metastases increased with progression of the depth of tumor infiltration. ES is not accurate for staging distant metastasis due to the limited penetration depth of ultrasound. Thus, additional transcutaneous ultrasound or computed tomography is necessary. Routine ES-guided cytology of lymph nodes may further enhance the diagnostic accuracy of ES.
对113例食管癌患者（第1组）和84例胃癌患者（第2组）术前进行了内镜超声检查（ES）。根据新的（1987年）TNM分类，将切除标本的影像学和组织学结果进行了相关性分析。ES在评估肿瘤浸润深度方面是准确的。第1组ES的总体准确率为89%，第2组为83%。早期癌可与进展期癌相鉴别。ES在诊断淋巴结转移方面是准确的（第1组敏感性为95%，第2组为87%），但在确定淋巴结炎症变化方面准确性较低（第1组特异性为50%，第2组为48%）。淋巴结转移的发生率随肿瘤浸润深度的进展而增加。由于超声穿透深度有限，ES对远处转移分期不准确。因此，需要额外进行经皮超声或计算机断层扫描。常规的ES引导下淋巴结细胞学检查可能会进一步提高ES的诊断准确性。
