Murata Y, Suzuki S, Ohta M, Mitsunaga A, Hayashi K, Yoshida K, Ide H
Department of Gastrointestinal Endoscopy, Tokyo Women's Medical College, Japan.
Gastrointest Endosc. 1996 Jul;44(1):23-8. doi: 10.1016/s0016-5107(96)70224-9.
In esophageal cancer it is important to distinguish between mucosal cancer and cancer invading the submucosa to determine the feasibility of endoscopic mucosal resection.
Endoscopic ultrasonography using a small probe 2.6 mm in diameter at 15 or 20 MHz frequency was employed to determine the depth of superficial esophageal cancer invasion in 54 patients. Group 1 consisted of 17 cases treated by endoscopic mucosal resection on the basis of ultrasonographic findings. Group II included 37 patients treated by conventional surgery. The resected specimens were compared with ultrasonographic findings.
The normal esophageal wall was depicted as having nine layers, the fourth hypoechoic layer (m4) on the high frequency image was confirmed to be the muscularis mucosa. Based on the ultrasound findings, cancer limited to the lamina propria was accurately determined in 84%. In the endoscopic mucosal resection cases, 15 were mucosal cancer whereas 2 cases had microscopic invasion of the submucosa.
High-frequency ultrasound probes were sufficiently accurate for the determination of the depths of invasion of early esophageal cancer to guide the application of endoscopic resection of mucosal cancer.
在食管癌中，区分黏膜癌和侵犯黏膜下层的癌症对于确定内镜黏膜切除术的可行性很重要。
使用直径2.6毫米、频率为15或20兆赫的小探头进行内镜超声检查，以确定54例浅表食管癌的浸润深度。第一组由17例根据超声检查结果接受内镜黏膜切除术的病例组成。第二组包括37例行传统手术的患者。将切除标本与超声检查结果进行比较。
正常食管壁显示有九层，高频图像上的第四层低回声层（m4）被确认为黏膜肌层。根据超声检查结果，84%的病例准确判断出癌症局限于固有层。在内镜黏膜切除病例中，15例为黏膜癌，2例有黏膜下层的微小浸润。
高频超声探头对于确定早期食管癌的浸润深度足够准确，可指导黏膜癌内镜切除术的应用。
