[Application of endoscopic ultrasonography to preoperative clinical staging of esophageal cancer].
OBJECTIVE
Preoperative clinical staging is the key to choose ideal therapy plan for esophageal cancer. Endoscopic ultrasonography (EUS), an accuracy diagnostic technique for TN staging of esophageal cancer, is used commonly in foreign countries, but seldom in China. This study was to evaluate the application of EUS to preoperative clinical staging of esophageal cancer.


METHODS
A total of 72 patients were examined preoperatively with EUS, and staged according to UICC (1997) TNM staging system. The EUS findings were compared with surgical pathologic findings.


RESULTS
The accuracy rates of T staging and N staging by EUS were 80.6% (58/72) and 88.9% (64/72), respectively. The accuracy rates of T staging were 50.0% (2/4) for T0, 75.0% (3/4) for T1, 70.6% (12/17) for T2, 90.0% (36/40) for T3, and 71.4% (5/7) for T4; those of N staging were 92.3% (36/39) for N0 and 84.8% (28/33) for N1, of which the accuracy rates of diagnosing mediastinum and abdomen lymph node metastases were 90.0% and 64.5%. The staging results by EUS were significantly accordant with those by surgical pathology: T staging, association coefficient = 0.687, P < 0.001; N staging, association coefficient = 0.878, P < 0.001. Twenty-two cases were staged incorrectly, including 14 cases of T staging, of which 8 cases were due to not distinguishing T2 and T3 correctly, and 8 cases of N staging, of which 5 cases were due to not distinguishing lymphadenitis and metastatic lymph nodes correctly.


CONCLUSIONS
The accuracy rate of EUS is high for preoperative staging of esophageal carcinoma, especially for T3 and mediastinum lymph node. Distinguishing T2 and T3, lymphadenitis and metastatic lymph nodes correctly and diagnosing abdomen lymph node metastasis can improve the diagnosis accuracy rate of EUS.
State Key Laboratory of Oncology in Southern China, Guangzhou, Guangdong, 510060, PR China.
Yi
Y
Hu
Jian-Hua
JH
Fu
Tie-Hua
TH
Rong
Guo-Liang
GL
Xu
Xiao-Dong
XD
Li
Peng-Yuan
PY
Zhang
Hong
H
Yang
Zhi-Hua
ZH
Zhu
Shi-Yi
SY
Zhang
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D019160:Endosonography; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011300:Preoperative Care; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery