Giovannini M, Seitz J F, Rabbia I, Perrier H, Colonna M A, Houvenaeghel G, Delpéro J R
Unité d'Oncologie Digestive, Institut Paoli-Calmettes, Marseille.
Gastroenterol Clin Biol. 1994;18(4):323-7.
The aim of this study was to evaluate the preoperative staging of rectal carcinoma by intrarectal ultrasonography using linear probe or curved array transducer. Between October 1991 and July 1993, preoperative staging with endoscopic ultrasound was performed in 45 patients with rectal carcinoma. Twenty-four received preoperative radiation therapy. For carcinoma of the middle and the lower part of rectum, the distance between the inferior pole of the tumour and the levator ani muscle was systematically measured. The ultrasound results were compared with histological and surgical findings. The staging was accurately predicted in 82.2% of cases. The depth of cancer invasion was correct in 93.3% (95.2% when preoperative radiation therapy was not applied and 79.1% after radiation therapy). Presence or absence of lymph nodes metastasis was correctly determined in 84.4% (90.5% when preoperative radiation therapy was not applied and 79.1% after radiation therapy). The distance between the inferior pole of the tumour and the levator ani muscle was correctly determined in 29/31 carcinoma of the middle and the lower part of rectum. While the linear and sectorial technique is more difficult when the tumour was circular, the staging of the lower part of rectum carcinoma and anal canal was easier.
本研究的目的是评估使用线阵探头或凸阵探头经直肠超声对直肠癌进行术前分期。1991年10月至1993年7月期间，对45例直肠癌患者进行了内镜超声术前分期。其中24例接受了术前放射治疗。对于直肠中下段癌，系统测量肿瘤下极与肛提肌之间的距离。将超声检查结果与组织学和手术结果进行比较。82.2%的病例分期预测准确。癌浸润深度判断正确的占93.3%（未进行术前放射治疗时为95.2%，放射治疗后为79.1%）。有无淋巴结转移判断正确的占84.4%（未进行术前放射治疗时为90.5%，放射治疗后为79.1%）。在31例直肠中下段癌中，有29例正确测定了肿瘤下极与肛提肌之间的距离。虽然当肿瘤呈圆形时，线阵和扇形技术操作更困难，但直肠癌下段和肛管的分期更容易。
