Yoshida M, Tsukamoto Y, Niwa Y, Goto H, Hase S, Hayakawa T, Okamura S
Second Department of Internal Medicine, Nagoya University School of Medicine, Japan.
Gastrointest Endosc. 1995 Jun;41(6):587-92. doi: 10.1016/s0016-5107(95)70196-6.
The present study was carried out to clarify the usefulness of and problems associated with a new ultrasound probe in the assessment of invasion of colorectal tumors. Normal colorectal wall of 23 resected specimens from colorectal cancer cases was examined in vitro with the probe. Fifty-one patients with colorectal carcinoma and 16 patients with rectal carcinoid tumor were presurgically examined using the probe via the biopsy channel of a conventional colonoscope. After endoscopic and ultrasonographic examination, 27 patients underwent endoscopic resection and 40 underwent surgical resection. The ultrasonographic findings were compared with histologic findings in all cases. Carcinomas and carcinoid tumors were visualized as an echo-poor region with the probe. The overall accuracy rate for depth of invasion was 76% (39/51) for colorectal cancer. The accuracy rates for tumors limited to the mucosa and tumors invading the submucosa were 83% and 90%, respectively; these rates were higher than those for tumors invading the muscularis propria (50%) and beyond the muscularis propria (73%). In all 16 cases of carcinoid tumor, the depth of invasion was accurately shown to be limited to the submucosa. This probe is useful to assess invasion of colorectal tumors, especially small and flat lesions limited to the mucosa or submucosa.
本研究旨在阐明一种新型超声探头在评估结直肠肿瘤浸润方面的实用性及相关问题。使用该探头对23例结直肠癌病例切除标本的正常结直肠壁进行体外检查。对51例结直肠癌患者和16例直肠类癌患者在术前通过传统结肠镜的活检通道使用该探头进行检查。在内镜和超声检查后，27例患者接受了内镜切除，40例接受了手术切除。所有病例均将超声检查结果与组织学结果进行比较。使用该探头可将癌和类癌肿瘤显示为低回声区。结直肠癌浸润深度的总体准确率为76%（39/51）。局限于黏膜层的肿瘤和侵犯黏膜下层的肿瘤准确率分别为83%和90%；这些准确率高于侵犯固有肌层（50%）和超出固有肌层（73%）的肿瘤。在所有16例类癌肿瘤病例中，浸润深度准确显示局限于黏膜下层。该探头有助于评估结直肠肿瘤的浸润情况，尤其是局限于黏膜层或黏膜下层的小而扁平病变。
