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影响超声内镜诊断早期食管癌准确性的临床病理因素。

Clinicopathologic factors influencing the accuracy of EUS for superficial esophageal carcinoma.

作者信息

Jung Jung Im, Kim Gwang Ha, I Hoseok, Park Do Youn, Kim Tae Kyun, Cho Young Hwa, Sung Yong Wan, Choi Mun Ki, Lee Bong Eun, Song Geun Am

机构信息

Jung Im Jung, Gwang Ha Kim, Tae Kyun Kim, Young Hwa Cho, Yong Wan Sung, Mun Ki Choi, Bong Eun Lee, Geun Am Song, Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan 602-739, South Korea.

出版信息

World J Gastroenterol. 2014 May 28;20(20):6322-8. doi: 10.3748/wjg.v20.i20.6322.

Abstract

AIM

To identify clinicopathologic factors influencing the accuracy of a high-frequency catheter probe endoscopic ultrasonography (EUS) for superficial esophageal carcinomas (SECs).

METHODS

A total of 126 patients with endoscopically suspected SEC, who underwent EUS and curative treatment at Pusan National University Hospital during 2005-2013, were enrolled. We reviewed the medical records of the 126 patients and compared EUS findings with histopathologic results according to clinicopathologic factors.

RESULTS

A total of 114 lesions in 113 patients were included in the final analysis. The EUS assessment of tumor invasion depth was accurate in 78.9% (90/114) patients. Accuracy did not differ according to histologic type, tumor differentiation, tumor location, or macroscopic shape. However, accuracy significantly decreased for tumors ≥ 3 cm in size (P = 0.002). Overestimation and underestimation of the invasion depth occurred for 11 (9.6%) and 13 lesions (11.4%), respectively. In multivariate analyses, tumor size ≥ 3 cm was the only factor significantly associated with EUS accuracy (P = 0.031), and was specifically associated with the underestimation of invasion depth.

CONCLUSION

EUS using a high-frequency catheter probe generally provides highly accurate assessments of SEC invasion depth, but its accuracy decreases for tumors ≥ 3 cm.

摘要

目的

确定影响高频导管探头内镜超声检查(EUS)对表浅食管癌(SEC)诊断准确性的临床病理因素。

方法

纳入2005年至2013年期间在釜山国立大学医院接受EUS检查及根治性治疗的126例内镜疑似SEC患者。我们回顾了这126例患者的病历,并根据临床病理因素将EUS检查结果与组织病理学结果进行比较。

结果

最终分析纳入了113例患者的114个病变。EUS对肿瘤浸润深度的评估在78.9%(90/114)的患者中是准确的。准确性在组织学类型、肿瘤分化程度、肿瘤位置或大体形态方面无差异。然而,对于大小≥3 cm的肿瘤,准确性显著降低(P = 0.002)。浸润深度的高估和低估分别发生在11个(9.6%)和13个病变(11.4%)中。在多因素分析中,肿瘤大小≥3 cm是唯一与EUS准确性显著相关的因素(P = 0.031),且与浸润深度的低估特别相关。

结论

使用高频导管探头的EUS通常能对SEC浸润深度进行高度准确的评估,但对于大小≥3 cm的肿瘤,其准确性会降低。

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