Nielsen M B, Pedersen J F, Christiansen J
Department of Radiology and Ultrasound, Glostrup Hospital, University of Copenhagen, Denmark.
Dis Colon Rectum. 1993 Mar;36(3):275-9. doi: 10.1007/BF02053510.
Preoperative evaluation of stenotic rectal tumors is important since they often involve adjacent organs and thus may require additional therapy. Previous reports on endosonographic staging have excluded stenotic tumors because they could not be fully visualized with the available equipment. In this study, we have evaluated the role of endosonography in staging stenotic rectal tumors, with special attention to the use of forward-looking endoprobes. Preoperative staging was performed in 28 patients with stenotic rectal tumors. Tumor extension was evaluated according to the TNM classification, and the results were compared with surgical and histopathologic findings. Endosonography accurately assessed tumor extension in two T2 tumors, 14 T3 tumors, and seven T4 tumors. Three T2 tumors were overstaged, and two T4 tumors were staged as T3. The accuracy was 82 percent. Twenty-two tumors were subject to histopathologic evaluation of lymph nodes. Lymph nodes larger than 1 cm had been seen by endosonography in eight patients, five of whom had nodal metastases. Lymph nodes smaller than 1 cm or no lymph nodes were found in 14 patients, four of whom had nodal metastases. In conclusion, full sonographic visualization of stenotic rectal tumors and thus evaluation of tumor extension can be achieved by using forward-looking endoprobes.
狭窄性直肠肿瘤的术前评估很重要，因为它们常累及相邻器官，因此可能需要额外的治疗。以往关于内镜超声分期的报告将狭窄性肿瘤排除在外，因为现有的设备无法对其进行完全可视化。在本研究中，我们评估了内镜超声在狭窄性直肠肿瘤分期中的作用，特别关注前瞻性内镜探头的使用。对28例狭窄性直肠肿瘤患者进行了术前分期。根据TNM分类评估肿瘤浸润深度，并将结果与手术和组织病理学检查结果进行比较。内镜超声准确评估了2例T2期肿瘤、14例T3期肿瘤和7例T4期肿瘤的肿瘤浸润深度。3例T2期肿瘤分期过高，2例T4期肿瘤被分期为T3期。准确率为82%。对22例肿瘤进行了淋巴结的组织病理学评估。内镜超声检查发现8例患者有大于1 cm的淋巴结，其中5例有淋巴结转移。14例患者未发现大于1 cm的淋巴结或无淋巴结，其中4例有淋巴结转移。总之，使用前瞻性内镜探头可以实现狭窄性直肠肿瘤的全超声可视化，从而评估肿瘤浸润深度。
