Wang J Y, Hsieh J S, Huang Y S, Huang C J, Hou M F, Huang T J
Department of Surgery, Kaohsiung Medical College, Taiwan.
Clin Imaging. 1998 Sep-Oct;22(5):355-9. doi: 10.1016/s0899-7071(98)00033-3.
We performed a prospective study from November 1989 to December 1996 to assess the accuracy of endoscopic ultrasonography (EUS) in the locoregional staging and resectability of patients with gastric carcinoma. One hundred and nineteen patients with gastric cancer who received preoperative assessment by EUS underwent subsequent surgery. The endosonographic tumor-node-metastasis (TNM) classification was used for comparison with the histopathologic findings of the resected specimens. The ability of EUS to accurately predict the T stage (depth of tumor invasion) and N stage (involvement of lymph node) was 70% and 65%, respectively. EUS displayed a tendency to overestimate T stage and underestimate N state. The differentiation of early gastric cancer from advanced gastric cancer showed a concordance rate of 89% and underestimation rate of 8% and underestimation rate of 3%. The accuracy of EUS in predicting the stage T1 to T3, which correspond to D0 resectability (no macroscopic or microscopic tumor remains), was 91%. In conclusion, these results revealed EUS as a valuable tool for evaluating the local staging and resectability of gastric cancer. We suggest that EUS should be introduced in the preoperative assessment of patients with gastric cancer.
我们于1989年11月至1996年12月进行了一项前瞻性研究，以评估内镜超声检查（EUS）在胃癌患者局部区域分期及可切除性评估中的准确性。119例接受EUS术前评估的胃癌患者随后接受了手术。采用内镜超声肿瘤-淋巴结-转移（TNM）分类与切除标本的组织病理学结果进行比较。EUS准确预测T分期（肿瘤浸润深度）和N分期（淋巴结受累情况）的能力分别为70%和65%。EUS表现出高估T分期和低估N分期的倾向。早期胃癌与进展期胃癌的鉴别诊断符合率为89%，低估率为8%，另有3%为低估。EUS预测对应D0可切除性（无肉眼或显微镜下肿瘤残留）的T1至T3期的准确性为91%。总之，这些结果表明EUS是评估胃癌局部分期及可切除性的有价值工具。我们建议在胃癌患者的术前评估中引入EUS。
