| 特集名 | EUS --大腸癌の断層像に迫る | |
|---|---|---|
| 題名 | 大腸腫瘍に対するEUSの実際 (2) sm癌の内視鏡治療のために a.EUSを用いた大腸sm癌の診断 | |
| 発刊年月 | 1999年 05月 | |
| 著者 | 趙 栄済 | 京都第二赤十字病院消化器科 |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Endscopic Ultrasonography for Colorectal Cancer | |
|---|---|---|
| Title | Endoscopic ultrasonography(EUS) in the diagnosis of depth of colorectal submucosal invasive cancer | |
| Author | Eisai Chou | Department of Gastroenterology, Kyoto Second Red Cross Hospital |
| [ Summary ] | We examined the usage of EUS in treatment of 60 cases of submucosal colorectal cancer between October 1985 and March 1999. EUS was performed with an echocolonoscope or ultrasonic probe, made by Olympus Co. Preoperative EUS diagnosis of submucosal cancer staging was compared with the histology of resected specimens. The normal colorectal wall was visualized as a five-layered structure. The third hyperechoic layer corresponded to the histological submucosal layer. EUS criteria for the depth of submucosal invasion were classified as SM1, SM2 and SM3, according to the depth of the deepest portion of the hypoechoic tumorous mass, compared with the equally divided three levels of the third hyperechoic layer in the vertical direction. EUS diagnosis was performed in 58 out of 60 cases. Based on the classification of the submucosal cancer invasion depth, usage of EUS made it possible to correctly diagnose sm1 in 10/20 (50%), sm2 in 9/ 15 (60%) and sm3 in 14/20 (70%). Overall accuracy rate for EUS were 57% (33/58). When EUS diagnosis was investigated as to whether the depth of tumor invasion was within the sm1 category or beyond sm2, overall accuracy rates for EUS were 83% (48/58). On the other hand, endoscopic diagnosis was obtained in 55 out of 60 cases in where the overall accuracy rate was 78% (43/55). Results of this study suggest that evaluation of the depth of invasion of colorectal submucosal cancer using EUS is a practical and important preoperative diagnostic procedure. |
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