Massari M, De Simone M, Cioffi U, Rosso L, Chiarelli M, Gabrielli F
Department of General and Thoracic Surgery, University of Milan, Ospedale Maggiore Policlinico IRCCS, Italy.
Surg Laparosc Endosc. 1998 Dec;8(6):438-44.
In rectal cancer, the depth of tumor infiltration and metastatic involvement of lymph nodes are important prognostic factors. Endosonography of the rectum, combining the advantages of both endoscopy and sonography, provides information not available from other imaging diagnostic techniques. From January 1989 to December 1997, 85 patients affected by rectal carcinoma were submitted to preoperative evaluation with endorectal ultrasonography. In 75 cases the results obtained with the endosonography were compared to the histology of the resected specimens. Overall accuracy in staging depth of infiltration was 90.7%. Overstaging occurred in 4% of patients, whereas understaging occurred in 5.3%. In staging lymph nodal involvement, overall accuracy was 76%, sensitivity was 69.8%, specificity was 84.4%, positive predictive value was 85.7%, and negative predictive value was 67.5%. Endorectal ultrasound is a safe and accurate diagnostic method for staging both tumor invasion and lymph node metastatic involvement, and for selecting an appropriate surgical strategy in patients affected by rectal cancer.
在直肠癌中，肿瘤浸润深度和淋巴结转移受累情况是重要的预后因素。直肠内超声检查结合了内镜检查和超声检查的优点，能提供其他影像诊断技术无法获得的信息。1989年1月至1997年12月，85例直肠癌患者接受了直肠内超声术前评估。其中75例患者的超声检查结果与切除标本的组织学检查结果进行了比较。浸润深度分期的总体准确率为90.7%。4%的患者存在分期过高情况，而5.3%的患者存在分期过低情况。在淋巴结受累分期方面，总体准确率为76%，敏感性为69.8%，特异性为84.4%，阳性预测值为85.7%，阴性预测值为67.5%。直肠内超声是一种安全、准确的诊断方法，可用于直肠癌患者肿瘤浸润和淋巴结转移受累的分期，以及选择合适的手术策略。
