Jayet C, Cuttat J F, Wassmer F A, Suter M
Service de chirurgie, CHUV, Lausanne.
Helv Chir Acta. 1994 Jul;60(5):687-9.
Endorectal ultrasonography has become the preferred exam to assess the local extent of rectal cancers. From 1990 to 1992, we have examined 28 patients with a rectal cancer. The tumours were classified according to the TNM. The objective of this exam is to identify patients whose tumours have invaded the perirectal fat. These patients are first treated in our clinic by an accelerated hyperfractionated radiotherapy and then operated. The preoperative staging made with the endorectal ultrasound was then compared with the anatomopathologic staging. The depth of the invasion was assessed precisely in 78.5% of cases. The exam's sensitivity to detect the invasion of the perirectal fat was 96% and its specificity 75%. Lymph node involvement was accurately identified in 67.8% of cases with a sensitivity of 81% and a specificity of 50%. This short retrospective study confirms that endorectal ultrasonography is a highly accurate tool for the staging of rectal carcinoma prior to operation and hence to select the patients that can benefit from preoperative irradiation.
直肠内超声检查已成为评估直肠癌局部范围的首选检查方法。1990年至1992年期间，我们对28例直肠癌患者进行了检查。肿瘤根据TNM进行分类。该检查的目的是识别肿瘤侵犯直肠周围脂肪的患者。这些患者首先在我们诊所接受加速超分割放疗，然后进行手术。然后将直肠内超声进行的术前分期与解剖病理分期进行比较。在78.5%的病例中精确评估了浸润深度。该检查检测直肠周围脂肪浸润的敏感性为96%，特异性为75%。在67.8%的病例中准确识别了淋巴结受累情况，敏感性为81%，特异性为50%。这项简短的回顾性研究证实，直肠内超声检查是术前对直肠癌进行分期的高度准确工具，因此有助于选择可从术前放疗中获益的患者。
