超声内镜在食管癌术前分期中的应用价值及存在的问题  

Endoscopic ultrasound for preoperative staging of esophageal cancer:Application value and problems encountered

作　　者：王金林[1] 陈倩[1] 吴小力[1] 王云[1] 侯伟[1] 郭巧珍[1] 陈念钧[1] 程斌[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院消化内科,湖北省武汉市430030

出　　处：《世界华人消化杂志》2017年第5期438-442,共5页World Chinese Journal of Digestology

摘　　要：目的探讨超声内镜(endoscopic ultrasonography,EUS)在食管癌分期中的应用价值及存在的问题.方法回顾性分析华中科技大学同济医学院附属同济医院2014-04/2016-09 388例食管癌患者的临床资料,计算EUS分期敏感性、特异性及准确性,比较梗阻及无梗阻患者临床特征.结果EUS对T1、T2、T3、T4期食管癌分期准确性分别为92.8%、82.9%、84.5%、95.4%.EUS判断有无淋巴结转移的敏感性为59.6%、特异性为81.8%、准确性为69.2%.梗阻组T3+期比例为79.5%,64.4%的患者已经出现淋巴结转移(N1+),均高于无梗阻组(P<0.05).结论EUS食管癌T分期准确性很高,是目前食管癌术前T分期首选方法.对于梗阻患者,无需扩张后行EUS分期,建议直接接受新辅助疗法.AIM To assess the value of endoscopic ultrasound（EUS） in preoperative staging of esophageal cancer and discuss the problems encountered.METHODS A retrospective review was conducted on 388 patients with esophageal cancer who underwent EUS examination and esophagectomy from April 2014 to September 2016 at our hospital.We calculated the sensitivity,specificity and accuracy of EUS in preoperative staging of esophageal cancer and compared the characteristics of the patients with and without stenosis.RESULTS The diagnostic accuracy of EUS for T1,T2,T3 and T4 stages was 92.8%,82.9%,84.5%,and95.4%,respectively.The sensitivity,specificity and accuracy of EUS for the diagnosis of N1＋were 59.6%,81.8%and 69.2%,respectively.In patients with stenosis,79.5%had T3＋and 64.4%had N1＋,both of which were significantly higher than those in patients without stenosis（P〈0.05）.CONCLUSION The accuracy of EUS in T staging in patients with esophageal cancer is high,and it is a reliable diagnostic tool.For patients with stenosis,pre-dilatation should be omitted and the patients should be referred for neoadjuvant therapy.

关 键 词：超声内镜 食管癌 术前分期 梗阻 

分 类 号：R735.1[医药卫生—肿瘤]