高频超声内镜在食管癌高发区早期癌及癌前病变诊治中的价值

Evaluation of Endoscopic Ultrasonography in the Diagnosis and Treatment of Early Esophageal Cancer and Precancerous Lesions in High-risk Areas

    摘要
  • 摘要:
      目的  探讨超声内镜在食管癌高发区早期癌及癌前病变诊断及治疗中的价值。
      方法  回顾分析2008年6月至2010年6月在食管癌高发区涉县、磁县进行普查发现的118例早期食管癌及癌前病变患者, 所有病例均行超声内镜(endoscopic ultrasonography, EUS)检查, 符合镜下治疗标准的内镜辅以碘染色并行内镜下黏膜切除术(endoscopic mucoscal resection, EMR), 余手术治疗。对所有行EMR术及手术治疗的患者术前EUS及术后病理结果进行对照分析。
      结果  EUS判断食管早期癌及癌前病变影像学结果显示: 黏膜层癌97例、黏膜下层癌21例, EUS与病理检查结果对照判断浸润深度, 结果相符者103例, 准确率87%, 其中对黏膜层癌判断的准确率90%, 对黏膜下层癌判断的准确率76%。
      结论  EUS准确评估病灶内镜可切除性, 使得内镜下黏膜切除手术更为安全有效, 对指导高发区早期食管癌和癌前病变内镜下治疗具有重要价值。

     

    Abstract:
      Objective  To study the significance of endoscopic ultrasonography (EUS) in the diagnosis and treatment of early esophageal cancer and precancerous lesions in high-risk areas.
      Methods  A total of 118 cases of early esophageal cancer and precancerous lesions were analyzed retrospectively based on EUS results performed in high-risk areas, i.e., She County and Ci County from June 2008 to June 2010. Endoscopic mucoscal resection (EMR) was performed on lesions that fulfilled the endoscopic treatment criteria, and the remaining lesions were removed surgically. After the resection, the invasion depth of the lesions was determined by an experienced pathologist and compared with the EUS estimation.
      Results  There were 97 cases of mucosal lesions and 21 cases of submucosal lesions diagnosed by EUS. Regarding the invasion depth, 87% (103 / 118) cases of EUS estimation were in accordance with the histopathological diagnosis. The diagnostic accuracy of EUS in mucosal and submucosal lesions was 90 % and 76 %, respectively.
      Conclusions  EUS is highly accurate for evaluating the feasibility of EMR for early esophageal cancer and precancerous lesions, thereby greatly improving the security and validity of EMR. EUS is very valuable in the endoscopic treatment of early esophageal cancer and precancerous lesions in high-risk areas.

     

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