用EUS探针诊断表浅的食管癌浸润深度:胶冻填充法和水填充气囊法的比较

作     者：Esaki M. Matsumoto T. Moriyama T. 陈瑜(译) 郑世成(校) 

作者机构：Department of Medicine and Clinical Science Graduate School of Medical Sciences Kyushu University Maidashi 3-1-1 Higashi-ku Fukuoka 812-8582 Japan 不详 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2006年第2卷第8期

页      面：26-27页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100214[医学-肿瘤学] 10[医学] 

主　　题：癌浸润深度 EUS 填充法 食管癌 气囊法 诊断 探针 黏膜下层 水 单中心研究 

摘      要：Background and Objective: Diagnostic accuracy of probe EUS depends on the constant maintenance of luminal medium for acoustic coupling. This study compared the accuracy of probe EUS by a jelly-filled method (EUS-J) and by a water-filled balloon method (EUS-W) for the assessment of invasion depth in superficial esophageal cancer. Design and Setting: A prospective, single-center study. Patients: Forty superficial esophageal cancers in 38 patients. Interventions: Patients were alternately assigned to EUS-J or EUS-W. The depth of invasion was classified into epitheliumor lamina propria mucosae (D1),muscularis mucosae or superficial layer of the submucosa (D2), and deep portion of the submucosa (D3). Depiction rate, interobserver variation between 2 observers, and accuracy for the determination of invasion depth were compared between EUS-J and EUS-W. Main Outcome Measurements and Results: Eighteen cancers were examined by EUS-J, and 22 cancers were examined by EUS-W. The actual depth of invasion was D1 in 21 cancers, D2 in 9 cancers, and D3 in 10 cancers. Depiction rate (94.4% vs 77.2% , P = .14) and interobserver agreement of EUS determination (82.3% vs 58.8% , P = .13) was higher in EUS-J than in EUS-W. The overall accuracy for the diagnosis of invasion depth was 77.8% in EUS-J and 59.1% in EUS-W (P = .18). The sensitivity for the diagnosis of D1 cancer was significantly higher in EUS-J than in EUS-W (100% vs 50% , P = .03), while the specificity was not different between the 2 procedures (81.8% vs 87.5% ). Conclusions: EUS-J is superior to EUS-W for the assessment of invasion depth in superficial esophageal cancer, especially for intramucosal cancer.