Gastroenterology Service of the Hospital de Clínicas de Porto Alegre (HCPA), Graduate Program in Medicine: Surgical Sciences, Faculty of Medicine, Federal University of Rio Grande do Sul (UFRGS), Port Alegre, Rio Grande do Sul, Brazil.
Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Federal University of Rio Grande do Sul (UFRGS), Port Alegre, Rio Grande do Sul, Brazil.
Ultrasound Med Biol. 2021 Jul;47(7):1657-1669. doi: 10.1016/j.ultrasmedbio.2021.03.013. Epub 2021 Apr 23.
Esophageal adenocarcinomas of the esophagus and esophagogastric junction constitute a global health problem, the incidence of which has increased in recent decades. It has a poor prognosis and a low 5-year survival rate. Its treatment is based on preoperative clinical staging, in which echoendoscopy plays an essential role. The aim of this study was to evaluate the current accuracy of echoendoscopy in the staging of esophageal and esophogogastric junction adenocarcinomas. A systematic review was performed in PubMed, Embase and Portal BVS using the search terms Esophageal Neoplasm, Esophagus Neoplasms, Esophagus Cancers, Esophageal Cancers, EUS, EUS-FNA, Endoscopic Ultrasonography, Echo Endoscopy, Endosonographies and Endoscopic Ultrasound, with subsequent meta-analysis of the data found. The accuracy of tumor (T) staging was 65.55%. For T1, sensitivity was 64.7%, and specificity 89.1%, with an accuracy of 89.6%. For T2, sensitivity and specificity were 35.7% and 89.2%, respectively, with an accuracy of 87.1%. For T3, sensitivity and specificity were 82.5% and 83%, respectively, with an accuracy of 87%. For T4, sensitivity and specificity were 38.6% and 94%, respectively, with an accuracy of 66.4%. For node (N) staging, sensitivity was 77.3% and specificity 67.4%, with an accuracy of 77.9%. Echoendoscopy exhibits suboptimal accuracy in preoperative staging of esophageal adenocarcinoma and esophagogastric junction.
食管和食管胃交界腺癌是一个全球性的健康问题，近年来其发病率有所增加。它的预后很差，5 年生存率很低。其治疗基于术前临床分期，其中超声内镜发挥着重要作用。本研究旨在评估超声内镜在食管和食管胃交界腺癌分期中的当前准确性。我们在 PubMed、Embase 和 Portal BVS 中使用了搜索词“食管肿瘤”、“食管肿瘤”、“食管癌”、“食管癌”、“EUS”、“EUS-FNA”、“内镜超声”、“超声内镜”、“超声内镜检查”和“内镜超声”进行了系统评价，并对发现的数据进行了荟萃分析。肿瘤（T）分期的准确性为 65.55%。对于 T1，敏感性为 64.7%，特异性为 89.1%，准确性为 89.6%。对于 T2，敏感性和特异性分别为 35.7%和 89.2%，准确性为 87.1%。对于 T3，敏感性和特异性分别为 82.5%和 83%，准确性为 87%。对于 T4，敏感性和特异性分别为 38.6%和 94%，准确性为 66.4%。对于淋巴结（N）分期，敏感性为 77.3%，特异性为 67.4%，准确性为 77.9%。超声内镜在食管腺癌和食管胃交界腺癌的术前分期中准确性不理想。
