Inui K, Nakazawa S
Department of Internal Medicine, Fujita Health University School of Medicine, Second Hospital, Toyoake, Japan.
Nihon Geka Gakkai Zasshi. 1998 Oct;99(10):696-9.
We reported on the usefulness of endosonography (EUS) in the diagnosis of the depth of invasion of gallbladder carcinoma. We performed EUS on 69 patients with gallbladder carcinoma: the degree of tumor extension in 17 was m (tumor invading the mucosa), in 5 pm (tumor invading the muscular layer), in 21 ss (tumor invading the subserosa), 14 in se (tumor invading the serosa), and 12 si (tumor extending to adjacent organs). The detection rate of tumors with EUS was 91.3% (63 of 69). All 6 (100%) patients with pedunculated lesions (Ip type) were correctly diagnosed with EUS. Eighteen of 21 patients (85.7%) with broad-based elevated tumors (Is type), and 5 of 7 (71.4%) with flat-elevated lesions (IIa type) were also diagnosed correctly. EUS is a useful modality for the diagnosis of gallbladder carcinoma. In particular, EUS diagnosis of the depth of invasion is reliable in Ip-type lesions. It is recommended that patients with Ip-type lesions undergo laparoscopic cholecystectomy, but in patients with Is-or IIa-type lesions conventional cholecystectomy with lymph node resection should be performed.
我们报道了内镜超声检查（EUS）在胆囊癌浸润深度诊断中的应用价值。我们对69例胆囊癌患者进行了EUS检查：肿瘤浸润程度为m（肿瘤侵犯黏膜）的有17例，pm（肿瘤侵犯肌层）的有5例，ss（肿瘤侵犯浆膜下层）的有21例，se（肿瘤侵犯浆膜）的有14例，si（肿瘤侵犯至邻近器官）的有12例。EUS对肿瘤的检出率为91.3%（69例中的63例）。所有6例（100%）有蒂病变（Ip型）患者均经EUS正确诊断。21例广基隆起性肿瘤（Is型）患者中的18例（85.7%）以及7例平坦隆起性病变（IIa型）患者中的5例（71.4%）也被正确诊断。EUS是诊断胆囊癌的一种有用方法。特别是，EUS对Ip型病变浸润深度的诊断是可靠的。建议Ip型病变患者行腹腔镜胆囊切除术，但对于Is型或IIa型病变患者，应行常规胆囊切除术并清扫淋巴结。
