微探头内镜超声检查对食管癌TNM分期的价值

Value of Endoscopic Ultrasonography with Miniature Probe in TNM Staging of Esophageal Cancer

背景:TNM分期对评估食管癌患者的疗效和预后至关重要,传统检查包括B超、CT、MRI仅对远处器官和淋巴结转移较敏感,不能很好地对患者进行T、N分期。内镜超声(EUS)能清楚显示食管壁层次和结构。目的:探讨微探头EUS检查对食管癌TNM分期的价值。方法:68例食管癌患者术前采用微探头EUS检查进行TNM分期,并与术后病理检查结果进行比较。结果:食管癌患者术前微探头EUS检查的T、N分期与术后病理分期符合率分别为82.4%和88.2%,其中T1、T2、T3、T4期的符合率分别为87.5%、75.0%、83.7%和80.0%,N0、N1期的符合率分别为83.9%和91.9%。结论:微探头EUS检查能较准确地判断食管癌的浸润深度和局部转移,对食管癌T、N分期有较高的准确率,在临床上有助于判断患者的病情和预后。

Background： TNM staging is crucial for evaluation of the therapeutic efficacy and prognosis of patients with esophageal cancer. Conventional examinations including uhrasonography, CT and MRI have high sensitivities in detecting remote organ and lymph node metastasis, but not good enough for T and N staging. Endoscopic uhrasonography can clearly demonstrate the layer and structure of esophageal wall. Aims： To investigate the value of endoscopic uhrasonography with miniature probe in TNM staging of esophageal cancer. Methods： Sixty-eight patients with esophageal cancer received endoscopic uhrasonography with miniature probe preoperatively, and were staged according to TNM staging system. The findings of endoscopic uhrasonography with miniature probe were compared with postoperative pathological findings. Results： The concordant diagnosis rates of T and N staging by endoscopic uhrasonography with miniature probe and pathological findings were 82.4% and 88.2%, respectively. The concordance rates of %, T2, T3 and T4 staging were 87.5%, 75.0%, 83.7% and 80.0%, respectively; the concordance rates of No and NI staging were 83.9% and 91.9%, respectively. Conclusions： Endoscopic uhrasonography with miniature probe is relatively accurate in assessing the depth of tumor infiltration and local metastasis. The accuracy rate of endoscopic uhrasonography with miniature probe is high for T and N staging of esophageal cancer, which is useful for the prediction of the patients＇ clinical condition and prognosis.