Roubein L D, David C, DuBrow R, Faintuch J, Lynch P, Fornage B, Levin B
Department of Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston.
Am J Gastroenterol. 1990 Oct;85(10):1391-4.
Endoscopic ultrasonography (EUS) was used to stage rectal cancer by assessing depth of invasion through bowel wall layers and/or involvement of lymph nodes. EUS findings were correlated with histopathologic findings to discern the usefulness of this modality in predicting which patients could be candidates for sphinctersaving procedures and the avoidance of abdominoperineal resection. The Olympus EU-M3 endoscopic ultrasound system was used to assess depth of penetration through rectal wall layers and to identify lymph nodes. Comparison of EUS findings to histopathologic findings was possible in 13 patients. EUS agreed with histopathology in 9 of 13 cases (69.3%) ( p = 0.07, kappa statistic). EUS agreed with histopathology as the presence or absence of lymph nodes in 9 of 13 cases (69.3%) (p = 0.07). However, the presence of lymph nodes could not necessarily predict metastatic involvement of these nodes. In one patient, invasion of vaginal cuff was correctly predicted. In nine cases, computed tomographic analysis (CT) was available for comparison to EUS in detection of penetration beyond the bowel wall. CT agreed with histopathology in 3 of 9 (33%), whereas EUS agreed with histopathology in 7 of 9 (78%).
内镜超声检查（EUS）通过评估肿瘤浸润肠壁各层的深度和/或淋巴结受累情况来对直肠癌进行分期。将EUS检查结果与组织病理学结果进行对比，以明确这种检查方式在预测哪些患者适合保留括约肌手术并避免腹会阴联合切除术方面的实用性。使用奥林巴斯EU-M3型内镜超声系统评估直肠壁各层的穿透深度并识别淋巴结。13例患者的EUS检查结果可与组织病理学结果进行对比。13例中有9例（69.3%）EUS检查结果与组织病理学结果相符（p = 0.07，kappa统计量）。13例中有9例（69.3%）EUS检查结果与组织病理学结果在淋巴结有无方面相符（p = 0.07）。然而，淋巴结的存在不一定能预测这些淋巴结是否发生转移。有1例患者阴道残端受侵被正确预测。9例患者中，在检测肠壁外侵犯方面，计算机断层扫描分析（CT）结果可与EUS结果进行对比。9例中有3例（33%）CT检查结果与组织病理学结果相符，而9例中有7例（78%）EUS检查结果与组织病理学结果相符。
