Gress F, Savides T, Cummings O, Sherman S, Lehman G, Zaidi S, Hawes R
Department of Pathology, Indiana University Medical Center, Indianapolis 46202-5000, USA.
Gastrointest Endosc. 1997 Feb;45(2):138-42. doi: 10.1016/s0016-5107(97)70236-0.
Endoscopic ultrasound (EUS) is known to be accurate for staging pancreatic cancer. Little data exist to determine if linear array or radial scanning EUS is superior for staging pancreatic cancer. This prospective comparison was undertaken to assess the accuracy of linear array and radial scanning EUS for staging pancreatic cancer.
Patients with pancreatic cancer referred for EUS staging were randomized to linear array or radial scanning EUS. Staging accuracy for each was determined by comparison to surgical pathology in those patients going to surgery.
Seventy-nine patients with pancreatic cancer were enrolled and 33 had surgical resection. Of these, 17 patients were randomized to linear array and 16 to radial scanning EUS. The remaining 46 patients did not have surgery because of comorbid illness or clinically unresectable disease. EUS staging accuracy for linear array was 94% (16 of 17) for T and 71% (12 of 17) for N staging, whereas radial scanning was 88% (14 of 16) for T and 75% (12 of 16) for N staging. For predicting vascular invasion, radial scanning was 100% accurate (16 of 16) while linear array was 94% (16 of 17) accurate. There was one false-negative assessment of invasion using linear array EUS.
Overall, both EUS designs appear equivalent for staging pancreatic cancer and assessing vascular invasion. In view of our findings and the capability for ultrasound-directed fine-needle aspiration with linear array EUS, this instrument may be the preferred choice for evaluating pancreatic masses.
已知内镜超声（EUS）在胰腺癌分期方面准确性较高。目前几乎没有数据可用于确定线阵或径向扫描EUS在胰腺癌分期方面是否更具优势。本前瞻性比较旨在评估线阵和径向扫描EUS在胰腺癌分期中的准确性。
因EUS分期而转诊的胰腺癌患者被随机分为线阵EUS组或径向扫描EUS组。对于接受手术的患者，通过与手术病理结果比较来确定每种方法的分期准确性。
79例胰腺癌患者入组，33例行手术切除。其中，17例患者被随机分配到线阵EUS组，16例被分配到径向扫描EUS组。其余46例患者因合并症或临床不可切除疾病未接受手术。线阵EUS的T分期准确性为94%（17例中的16例），N分期准确性为71%（17例中的12例），而径向扫描的T分期准确性为88%（16例中的14例），N分期准确性为75%（16例中的12例）。在预测血管侵犯方面，径向扫描的准确性为100%（16例中的全16例），而线性阵列的准确性为94%（17例中的16例）。使用线阵EUS时有1例假阴性侵犯评估。
总体而言，两种EUS设计在胰腺癌分期和评估血管侵犯方面似乎相当。鉴于我们的研究结果以及线阵EUS进行超声引导下细针穿刺的能力，该设备可能是评估胰腺肿块的首选。
