食管腔内超声在食管良恶性肿瘤诊断中的应用

Transesophageal intraluminal ultrasonography in diagnosis of esophageal benign and malignant tumor

目的 研究经食管探头超声仪（ Ｔ Ｅ Ｅ Ｐ） 在食管良、恶性肿瘤诊断中的应用价值。方法３２ 例食管癌患者和１１ 例食管粘膜下肿瘤患者术前均进行上消化道钡餐、纤维胃镜和 Ｔ Ｅ Ｅ Ｐ 等检查。其中７ 例食管癌患者和８ 例食管粘膜下肿瘤患者术前还予以 Ｃ Ｔ扫描检查。所有切除的标本，包括淋巴结，均送病理检查，并将术前 Ｔ Ｅ Ｅ Ｐ 和 Ｃ Ｔ 检查情况与术中、术后病理结果进行对比分析。结果 Ｔ Ｅ Ｅ Ｐ术前食管癌 Ｔ、 Ｎ 分期的准确率分别为８１ ％ （２５／３１） 和７７ ％ （３３／４４） ，而 Ｃ Ｔ 术前 Ｔ 分期的准确率仅为４３ ％ （３／７） 。对于食管平滑肌瘤， Ｔ Ｅ Ｅ Ｐ 术前诊断与术后病理结果完全相同，而 Ｃ Ｔ术前诊断的准确率仅为５０ ％ （４／８） 。结论 无论是对食管癌的术前 Ｔ Ｎ 分期，还是对食管平滑肌瘤的术前诊断， Ｔ Ｅ Ｅ Ｐ都是一项准确、可靠的检查手段。

Objective To study the value of transesophageal echo probe(TEEP) in the management of the esophageal benign and malignant tumor Methods 32 patients with esophageal carcinoma and 11 patients with esophageal submucosal tumor underwent surgery Preoperative examinations included upper gastrointestinal series, endoscopy, and TEEP Among these patients, preoperative CT scan was also done in 7 patients with esophageal carcinoma and 8 patients with esophageal submucosal tumor All the resected specimens, including lymph nodes, were examined histopathologically, and the results of preoperative study of TEEP and CT were compared respectively with both the intraoperative macroscopic findings and the pathologic examination of the resected specimens Results For T staging of 31 patients with esophageal carcinoma,TEEP was 81%(25/31) accurate versus 43%(3/7) for CT. The accuracy of TEEP for predicting N staging was 77% (34/44) For eleven patients with esophageal liomyoma, the preoperative diagnosis of TEEP was the same as the result of pathology, but the diagnostic accuracy of CT was only 50 0% (4/8) Conclusion TEEP is a reliable method for the preoperative TN staging of esophageal carcinoma and diagnosis of esophageal liomyoma Moreover, it is more accurate than CT In our experience,the procedure was safe and no complication occurred