Tio T L, Sie L H, Kallimanis G, Luiken G J, Kimmings A N, Huibregtse K, Tytgat G N
Georgetown University Hospital, Division of Gastroenterology, Washington DC, USA.
Gastrointest Endosc. 1996 Dec;44(6):706-13. doi: 10.1016/s0016-5107(96)70056-1.
The aim of the study was to update our previously published data on the clinical TNM staging of ampullary and pancreatic carcinoma by endosonography.
Endosonography was performed in 70 patients with pancreatic cancer and in 32 patients with ampullary carcinoma. TNM staging was carried out before surgery and compared with findings of histology and/or surgery.
Endosonography was accurate in staging the depth of tumor invasion. Early-stage carcinomas could be distinguished from advanced cancers. Nonresectability was accurately assessed on the basis of vascular involvement using real-time ultrasound. Tumor compression due to peritumoral pancreatitis and direct tumor invasion into the base of the mesocolon could not be diagnosed by endosonography. The overall accuracy in tumor staging for pancreatic and ampullary carcinomas was 83.6% and 84.4%, respectively. Endosonography was accurate in diagnosing regional lymph node metastases but not accurate in defining nonmetastatic lymphadenopathy and distant metastases.
Endosonography was accurate in staging tumor stage and lymph node metastases. Minimally invasive methods of resection for superficial ampullary cancers should be based on endosonography staging.
本研究的目的是更新我们之前发表的关于通过内镜超声对壶腹癌和胰腺癌进行临床TNM分期的数据。
对70例胰腺癌患者和32例壶腹癌患者进行了内镜超声检查。在手术前进行TNM分期，并与组织学和/或手术结果进行比较。
内镜超声在肿瘤浸润深度分期方面准确。早期癌可与进展期癌区分开来。基于实时超声对血管受累情况的评估可准确判断不可切除性。内镜超声无法诊断肿瘤周围胰腺炎导致的肿瘤压迫以及肿瘤直接侵犯结肠系膜根部。胰腺癌和壶腹癌肿瘤分期的总体准确率分别为83.6%和84.4%。内镜超声在诊断区域淋巴结转移方面准确，但在定义无转移淋巴结病和远处转移方面不准确。
内镜超声在肿瘤分期和淋巴结转移分期方面准确。浅表壶腹癌的微创切除方法应基于内镜超声分期。
