Nattermann C, Dancygier H
Medizinische Klinik II, Städtischen Kliniken Offenbach.
Ultraschall Med. 1993 Jun;14(3):100-5. doi: 10.1055/s-2007-1005226.
In 86 patients with histologically proven oesophageal carcinoma endoscopic ultrasonography (EUS) and computerised tomography (CT) were performed during TN-staging (UICC 1987). 44 patients were operated on and the histological findings were compared with the results of preoperative staging. The T-stage was correctly determined with EUS and CT in 35 (80%) and 24 (55%) patients, respectively. The accuracy of EUS was 75%, 71%, 91% and 67% in stages T1 to T4. The sensitivity of EUS in the diagnosis of lymph node metastases was 91%, that of CT 42%. The specificity of EUS and CT was 64% and 100%, respectively. The accuracy for pN staging (N0/N1) was 84% with EUS and 57% with CT. The presence of local lymph node metastases was closely correlated to the pT-stage (1 patient [14%] with pT1-, 5 patients [71%] with pT2-, 21 patients [95%] with pT3- and 6 patients [100%] with pT4-stage). In 12 out of 34 patients (28%) tumour induced stenosis prevented a complete oesophageal passage of the EUS probe. This fact, however, did not compromise TN-staging significantly. Our study demonstrates that EUS is an efficient method in the locoregional staging of oesophageal carcinoma. Especially in the early tumour stages T1 and T2 and in the demonstration of local lymph node metastases EUS is superior to CT.
对86例经组织学证实的食管癌患者在TN分期（UICC 1987）期间进行了内镜超声检查（EUS）和计算机断层扫描（CT）。44例患者接受了手术，并将组织学检查结果与术前分期结果进行了比较。EUS和CT对T分期的正确判断分别为35例（80%）和24例（55%）患者。EUS在T1至T4期的准确率分别为75%、71%、91%和67%。EUS诊断淋巴结转移的敏感性为91%，CT为42%。EUS和CT的特异性分别为64%和100%。EUS对pN分期（N0/N1）的准确率为84%，CT为57%。局部淋巴结转移的存在与pT分期密切相关（1例[14%]pT1期、5例[71%]pT2期、21例[95%]pT3期和6例[100%]pT4期）。34例患者中有12例（28%）因肿瘤导致的狭窄妨碍了EUS探头完全通过食管。然而，这一事实并未显著影响TN分期。我们的研究表明，EUS是食管癌局部区域分期的一种有效方法。尤其是在肿瘤早期T1和T2期以及在显示局部淋巴结转移方面，EUS优于CT。
