Nielsen M B, Qvitzau S, Pedersen J F, Christiansen J
Department of Radiology and Ultrasound, Glostrup Hospital, University of Copenhagen, Denmark.
Acta Radiol. 1996 Sep;37(5):799-803. doi: 10.1177/02841851960373P273.
The aim of this study was to evaluate the use of rectal endosonography for preoperative staging of tumour extension and lymph node involvement in rectal tumours.
Over a 4-year period 100 patients with rectal tumours were studied with sonography using 7 MHz endoprobes. Tumour spread was assessed according to the TNM classification, and the number and maximum size of perirectal lymph nodes were registered. The sonographic findings were compared with the surgical and histological findings.
The overall accuracy of endosonography in assessing local tumour extension was 85% (76-91%; 95 percent confidence limits). T4 tumours with a large contact surface to an adjacent organ tended to be nonresectable. Lymph node assessment could be made in 81 patients who underwent radical resection: sonography showed lymph nodes in 49 patients, 30 of whom had nodal metastases; the histological examination showed lymph nodes in the remaining 32 patients, 8 of whom had nodal metastases. The number of lymph nodes at the histological examination was markedly higher than the number depicted by preoperative ultrasound.
This study confirmed the use of endoluminal ultrasound in the preoperative evaluation of local tumour spread. However, endosonographic assessment of perirectal nodal involvement seems to be too unreliable to be used for the preoperative selection of patients.
本研究旨在评估直肠内超声在直肠癌术前肿瘤浸润范围及淋巴结受累情况分期中的应用。
在4年期间，对100例直肠肿瘤患者使用7MHz的腔内探头进行超声检查。根据TNM分类评估肿瘤扩散情况，并记录直肠周围淋巴结的数量和最大直径。将超声检查结果与手术及组织学检查结果进行比较。
超声检查评估局部肿瘤浸润的总体准确率为85%（76 - 91%；95%置信区间）。与相邻器官有大面积接触面的T4肿瘤往往无法切除。对81例行根治性切除术的患者进行了淋巴结评估：超声检查显示49例有淋巴结，其中30例有淋巴结转移；组织学检查显示其余32例有淋巴结，其中8例有淋巴结转移。组织学检查发现的淋巴结数量明显多于术前超声显示的数量。
本研究证实了腔内超声在术前评估局部肿瘤扩散中的应用。然而，直肠周围淋巴结受累的超声检查评估似乎过于不可靠，无法用于术前患者选择。
