Hizawa K, Suekane H, Aoyagi K, Matsumoto T, Nakamura S, Fujishima M
Second Department of Internal Medicine, Kyushu University, Fukuoka, Japan.
Am J Gastroenterol. 1996 Apr;91(4):768-71.
To determine the efficacy with which endoscopic ultrasonography (EUS) is able to differentiate between mucosal and submucosal invasion for application of endoscopic resection.
We prospectively analyzed 60 patients who were diagnosed with early cancer by conventional EUS with regard to the accuracy of mucosal neoplasia as a function of gender, age, location, size, endoscopic configuration, histological diagnosis, and method of resection.
Forty lesions interpreted as mucosal by EUS were shown histologically to include 32 lesions in the mucosa and eight in the submucosa or deeper, whereas 20 tumors interpreted as invasive cancer included six lesions in the mucosa and 14 in the submucosa or deeper. The accuracy of mucosal neoplasia (AMN) detection was 77% (true-positive and true-negative mucosal neoplasias divided by all lesions). Assessment of pure cancers without adenomatous components produced a significantly lower AMN (59%, p = 0.03) than the assessment of pure adenomas (95%) or cancers in adenomas (87%). However, there were no significant differences in the EUS assessment of intramucosal neoplasia as a function of sex, age, endoscopic configuration, size, location, or treatment.
We conclude that conventional EUS interpretation alone cannot determine the appropriate treatment for early colorectal cancer.
确定内镜超声检查（EUS）在区分黏膜浸润和黏膜下浸润以应用于内镜切除方面的效能。
我们前瞻性分析了60例经传统EUS诊断为早期癌症的患者，根据性别、年龄、部位、大小、内镜形态、组织学诊断和切除方法，分析黏膜肿瘤形成的准确性。
EUS判定为黏膜内的40个病变经组织学检查显示，其中32个位于黏膜层，8个位于黏膜下层或更深层；而判定为浸润性癌的20个肿瘤中，6个位于黏膜层，14个位于黏膜下层或更深层。黏膜肿瘤形成（AMN）检测的准确率为77%（真阳性和真阴性黏膜肿瘤形成数除以所有病变数）。对无腺瘤成分的单纯癌进行评估时，AMN（59%，p = 0.03）显著低于对单纯腺瘤（95%）或腺瘤性癌（87%）的评估。然而，EUS对黏膜内肿瘤形成的评估在性别、年龄、内镜形态、大小、部位或治疗方面无显著差异。
我们得出结论，仅靠传统的EUS解读无法确定早期结直肠癌的合适治疗方法。
