Zhang Yueming, He Shun, Dou Lizhou, Liu Yong, Ke Yan, Yu Xinying, Wang Zhu, Wang Guiqi
Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R. China.
Department of Medical Image, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R. China.
Oncol Lett. 2019 Jan;17(1):863-870. doi: 10.3892/ol.2018.9716. Epub 2018 Nov 16.
Esophageal cancer staging is important for the treatment of esophageal cancer. Endoscopic ultrasonography (EUS) is a common diagnostic tool for esophageal cancer prior to surgery. However, EUS is unable to accurately discriminate the N-staging of lymph nodes. In order to distinguish an optimized standard for malignant lymph node diagnosis, the present study compared lymph nodes detected by EUS and surgery. A total of 112 patients were preoperatively examined with EUS and staged according to the 7th Edition of the American Joint Committee on Cancer Staging Manual. The results of EUS were compared with surgical findings. The critical values of long diameter, short diameter and lymph node number detected by EUS were >7.5, >5.5 mm and >2, respectively; indexes, including long diameter >7.5 mm, short diameter >5.5 mm, round, low echo, edge smooth, near lesion and detected lymph node number (>2) and T3/4 staging, met significance in the EUS group compared with the surgical group (P<0.05). Furthermore, the area under curve (AUC) value of the EUS (0.801) was superior to the conventional, surgical method (0.779). Although EUS improved the diagnostic accuracy of esophageal N staging, it was not able to satisfactorily distinguish between N2 and N3 staging. Advancements in EUS may enhance its detection ability, further improving the diagnostic accuracy of lymph node metastasis.
食管癌分期对于食管癌的治疗很重要。内镜超声检查（EUS）是术前食管癌常用的诊断工具。然而，EUS无法准确区分淋巴结的N分期。为了确定恶性淋巴结诊断的优化标准，本研究比较了EUS和手术检测到的淋巴结。共有112例患者术前接受EUS检查，并根据美国癌症联合委员会第7版分期手册进行分期。将EUS结果与手术结果进行比较。EUS检测到的长径、短径和淋巴结数量的临界值分别为>7.5、>5.5mm和>2；与手术组相比，EUS组中长径>7.5mm、短径>5.5mm、圆形、低回声、边缘光滑、靠近病变以及检测到的淋巴结数量（>2）和T3/4分期等指标具有统计学意义（P<0.05）。此外，EUS的曲线下面积（AUC）值（0.801）优于传统的手术方法（0.779）。虽然EUS提高了食管N分期的诊断准确性，但它不能令人满意地区分N2和N3分期。EUS的进展可能会提高其检测能力，进一步提高淋巴结转移的诊断准确性。
